| NPI | 1992875314 |
|---|---|
| Former Name | JESSICA ANN SHATTUCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT00009591) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00009591) |
| 2251S0007X Physical Therapist, Sports (Licence: WA PT00009591) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-10-19 |