| NPI | 1841728813 |
|---|---|
| Former Name | JORDAN LYN OVERLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 087866) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2022-05-10 |