| NPI | 1982867743 |
|---|---|
| Former Name | JENNIFER LOREN SELF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH6224) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: AL 6224) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-07-22 |