Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1375 | NM |
N | 2251E1200X | Ergonomics | 1375 | NM |
N | 225XE1200X | Ergonomics | 1375 | NM |
N | 2251S0007X | Physical Therapist - Sports | 1375 | NM |
N | 2251X0800X | Physical Therapist - Orthopedic | 1375 | NM |
NPI | 1134220007 |
---|---|
Provider Name | Jennifer L Wilkins |
First Address | Warrenton, VA 20186-3008 |
Second Address | Warrenton, VA 20186-3008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 17/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
41621085 | (05) | NM |