NPI | 1952610412 |
---|---|
Former Name | JENNIFER L MONROE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 9105PT) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-11128) |
Enumeration Date | 2010-10-01 |
Last Update Date | 2014-11-06 |