Provider Demographics
NPI:1164532289
Name:SCANLAN, JAYNE M (MS PT)
Entity Type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:M
Last Name:SCANLAN
Suffix:
Gender:F
Credentials:MS PT
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Mailing Address - Street 1:4273 KEATON CROSSING BLVD
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8220
Mailing Address - Country:US
Mailing Address - Phone:636-206-6540
Mailing Address - Fax:636-422-1051
Practice Address - Street 1:4131 UNION RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1064
Practice Address - Country:US
Practice Address - Phone:314-274-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2003013786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist