NPI | 1922590223 |
---|---|
Former Name | JENNA GIESICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2105) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2018-06-01 |
Last Update Date | 2022-08-01 |