Provider Demographics
NPI:1669507422
Name:HIGHBARGER, JENNIFER ADELSTEIN (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ADELSTEIN
Last Name:HIGHBARGER
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 1:6351 W ROUTE K
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-8865
Mailing Address - Country:US
Mailing Address - Phone:573-268-3953
Mailing Address - Fax:
Practice Address - Street 1:3315 BERRYWOOD DR STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6571
Practice Address - Country:US
Practice Address - Phone:573-875-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101403174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist