| NPI | 1942235726 |
|---|---|
| Former Name | JENNIFER L TANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60277353) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 297376) |
| 225100000X Physical Therapist (Licence: OR 5020) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-09-24 |