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Individual
JENNIFER SUSANN CROSSLAND
Active
Individual
JENNIFER SUSANN CROSSLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1128387
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111408402
—
TX
01
—
1128387
LICENSE #
TX
Enumeration date
06/18/2007
Last updated
07/09/2007
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