Provider Demographics
NPI:1750631354
Name:GAEWSKY, JENNIFER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GAEWSKY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13642 N HWY 183
Mailing Address - Street 2:BUILDING 2, SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2265
Mailing Address - Country:US
Mailing Address - Phone:512-331-4115
Mailing Address - Fax:
Practice Address - Street 1:13642 N HWY 183
Practice Address - Street 2:BUILDING 2, SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2265
Practice Address - Country:US
Practice Address - Phone:512-331-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24190225100000X
CT9504225100000X
VA2305207595225100000X
TX1225590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist