Provider Demographics
NPI:1003069956
Name:ADVENT, JENNIFER LYNN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:ADVENT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1045 BEECHER XING N
Mailing Address - Street 2:SUITE C
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4573
Mailing Address - Country:US
Mailing Address - Phone:614-775-9618
Mailing Address - Fax:614-775-9633
Practice Address - Street 1:1045 BEECHER XING N
Practice Address - Street 2:SUITE C
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-4573
Practice Address - Country:US
Practice Address - Phone:614-775-9618
Practice Address - Fax:614-775-9633
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist