| 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 |