| NPI | 1780466227 |
|---|---|
| Former Name | JEROME VENTRESS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 133VN1301X Dietitian, Registered Nutrition, Oncology |
| 225200000X Physical Therapy Assistant | |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2023-10-18 |