NPI | 1992321590 |
---|---|
Former Name | JESSICA M EBERHARDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014616) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10268) |
Enumeration Date | 2020-06-19 |
Last Update Date | 2023-05-23 |