Individual
MS. JENNY REBECCA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
53381592401
UT
225100000X
Physical Therapist
Primary
53381592401
UT
Other
Enumeration date
10/26/2005
Last updated
11/04/2024
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