NPI | 1982893855 |
---|---|
Former Name | JESSICA LYNN WORRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT002657) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT016087) |
Enumeration Date | 2007-10-17 |
Last Update Date | 2022-11-05 |