| NPI | 1891889796 |
|---|---|
| Former Name | JESSICA PENNINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019878) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 026657-1) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-09-10 |