| NPI | 1831321736 |
|---|---|
| Former Name | JEAN L FREDMUND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 006742L) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT006742L) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2023-08-23 |