Provider Demographics
NPI:1245615590
Name:DELF, JENN (MPT)
Entity Type:Individual
Prefix:
First Name:JENN
Middle Name:
Last Name:DELF
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 APPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-4883
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13610 BARRETT OFFICE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-7816
Practice Address - Country:US
Practice Address - Phone:314-822-5107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007037087225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist