NPI | 1912795220 |
---|---|
Former Name | JENNIFER AVERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12794) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00009463) |
Enumeration Date | 2025-04-28 |
Last Update Date | 2025-07-17 |