NPI | 1932432275 |
---|---|
Former Name | JESSICA L JENNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 26356) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 031679-1) |
225100000X Physical Therapist (Licence: NC 12714) | |
Enumeration Date | 2009-09-17 |
Last Update Date | 2021-04-02 |