Provider Demographics
NPI:1073285698
Name:CORTINA, JOLENE MARIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOLENE
Middle Name:MARIE
Last Name:CORTINA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-2013
Mailing Address - Country:US
Mailing Address - Phone:814-594-6871
Mailing Address - Fax:
Practice Address - Street 1:20 N MICHAEL ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-1394
Practice Address - Country:US
Practice Address - Phone:814-245-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist