Provider Demographics
NPI:1669045191
Name:CHRISTOPHEL, JENNIFER (LMT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CHRISTOPHEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 ORD ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:PA
Mailing Address - Zip Code:15558-9004
Mailing Address - Country:US
Mailing Address - Phone:814-242-6418
Mailing Address - Fax:
Practice Address - Street 1:23789 GARRETT HWY
Practice Address - Street 2:
Practice Address - City:MC HENRY
Practice Address - State:MD
Practice Address - Zip Code:21541-1338
Practice Address - Country:US
Practice Address - Phone:814-242-6418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019018358225700000X
DCMT2000029225700000X
PAMSG014199225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist