| NPI | 1821219585 |
|---|---|
| Former Name | JENNA DANIELLE PEITZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.12922) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501011483) |
| 225100000X Physical Therapist (Licence: OH PT10373) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-05-17 |