| NPI | 1801184205 |
|---|---|
| Former Name | JOLENE BLUNT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 17133-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-018451) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2025-05-30 |