Individual
JENNIFER SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA,CLT
Contact information
Practice address
724 W. RENDON CROWLEY RD, FORT WORTH, TX 76036
(817) 297-4141
Mailing address
2106 NUGENT DR, MANSFIELD, TX 76063-5125
(619) 246-6779
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2058517
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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