Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant |
NPI | 1013563709 |
---|---|
Provider Name | Jennifer Rautenstrauch |
First Address | Getzville, NY 14068-1231 |
Second Address | Getzville, NY 14068-1231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2019 |
Last Update Date | 18/08/2019 |