Provider Demographics
NPI:1649422593
Name:TUOHY, JENNIFER (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:TUOHY
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 1:88 NORWICH NEW LONDON TPKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-2518
Mailing Address - Country:US
Mailing Address - Phone:860-848-9157
Mailing Address - Fax:860-848-3471
Practice Address - Street 1:88 NORWICH NEW LONDON TPKE
Practice Address - Street 2:SUITE 1
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-2518
Practice Address - Country:US
Practice Address - Phone:860-848-9157
Practice Address - Fax:860-848-3471
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist