| NPI | 1770750085 |
|---|---|
| Former Name | JANA MARY WARDWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT26403) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT3303) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2018-09-12 |