Provider Demographics
NPI:1740243146
Name:MCDOWELL, JENNIFER R (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:R
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:R
Other - Last Name:STARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:520 PELLIS RD
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4777
Mailing Address - Country:US
Mailing Address - Phone:724-850-7587
Mailing Address - Fax:724-850-9909
Practice Address - Street 1:1025 LATROBE THIRTY PLZ
Practice Address - Street 2:SUITE 121
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2865
Practice Address - Country:US
Practice Address - Phone:724-532-0940
Practice Address - Fax:724-532-0945
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013506L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018380700002Medicaid
PA0018380700001Medicaid
PAP29587Medicare UPIN
PA0018380700002Medicaid