| NPI | 1881838985 |
|---|---|
| Former Name | JENNIFER LYNN RIDGELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 19253) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT017669) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2018-09-20 |