Provider Demographics
NPI:1043575475
Name:DELAVAN, JENNIFER SAAR (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SAAR
Last Name:DELAVAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 WEST ST
Mailing Address - Street 2:
Mailing Address - City:TABOR
Mailing Address - State:IA
Mailing Address - Zip Code:51653-2028
Mailing Address - Country:US
Mailing Address - Phone:402-740-7030
Mailing Address - Fax:
Practice Address - Street 1:603 ROSARY DR
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:IA
Practice Address - Zip Code:50841-1683
Practice Address - Country:US
Practice Address - Phone:641-322-6249
Practice Address - Fax:641-322-6350
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist