| NPI | 1982947370 |
|---|---|
| Former Name | JENNIFER MARIE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10146) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11987-24) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2020-04-03 |