Provider Demographics
NPI:1275715385
Name:SPINELLI, JENNIFER A (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:SPINELLI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:ONARECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:825 N BROADWAY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-6039
Mailing Address - Country:US
Mailing Address - Phone:405-609-3670
Mailing Address - Fax:405-605-8638
Practice Address - Street 1:6904 E RENO AVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-2152
Practice Address - Country:US
Practice Address - Phone:405-610-2488
Practice Address - Fax:405-610-2484
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0190482251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic