Provider Demographics
NPI:1467776419
Name:RESMONDO, JENNY (MS, PT)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:RESMONDO
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16920 KOPTIS RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERDALE
Mailing Address - State:AL
Mailing Address - Zip Code:36580-3843
Mailing Address - Country:US
Mailing Address - Phone:251-964-7910
Mailing Address - Fax:
Practice Address - Street 1:16920 KOPTIS RD
Practice Address - Street 2:
Practice Address - City:SUMMERDALE
Practice Address - State:AL
Practice Address - Zip Code:36580-3843
Practice Address - Country:US
Practice Address - Phone:251-236-4855
Practice Address - Fax:251-517-4127
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3664225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist