Provider Demographics
NPI:1326390477
Name:KOHR, JENNY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LYNN
Last Name:KOHR
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 1:2583 WALTER GREEN CMNS
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-2449
Mailing Address - Country:US
Mailing Address - Phone:440-428-6260
Mailing Address - Fax:440-428-6276
Practice Address - Street 1:2583 WALTER GREEN CMNS
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2449
Practice Address - Country:US
Practice Address - Phone:440-428-6260
Practice Address - Fax:440-428-6276
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT013969225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist