Provider Demographics
NPI:1578867396
Name:KRAJEWSKI, JENNA EDDY (DPT)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:EDDY
Last Name:KRAJEWSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 BRANCH MILLS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHINA
Mailing Address - State:ME
Mailing Address - Zip Code:04358-5411
Mailing Address - Country:US
Mailing Address - Phone:207-624-2402
Mailing Address - Fax:
Practice Address - Street 1:91 CAMDEN ST STE 307
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2421
Practice Address - Country:US
Practice Address - Phone:207-593-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-09
Last Update Date:2011-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist