| NPI | 1841363249 |
|---|---|
| Other Name | JAKE SHAWN BLEACHER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 4328) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 011759) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-08 |