Provider Demographics
NPI:1346736428
Name:ANDERSON, JENNIFER LINDSEY (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LINDSEY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LINDSEY
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 GARDEN GROVE DR
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16002-3803
Mailing Address - Country:US
Mailing Address - Phone:412-310-8955
Mailing Address - Fax:
Practice Address - Street 1:134 MARWOOD RD
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:PA
Practice Address - Zip Code:16023-2206
Practice Address - Country:US
Practice Address - Phone:724-352-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026934225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist