NPI | 1841671195 |
---|---|
Former Name | JESSICA WOODWORTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 3974) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21720) |
Enumeration Date | 2015-06-12 |
Last Update Date | 2024-09-15 |