Provider Demographics
NPI:1275567208
Name:KREPFLE, JODI ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:ANN
Last Name:KREPFLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LAFAYETTE PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2209
Mailing Address - Country:US
Mailing Address - Phone:843-342-7330
Mailing Address - Fax:843-342-9101
Practice Address - Street 1:12 LAFAYETTE PL
Practice Address - Street 2:SUITE A
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2209
Practice Address - Country:US
Practice Address - Phone:843-342-7330
Practice Address - Fax:843-342-9101
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ337428318Medicare PIN