Provider Demographics
NPI:1790119949
Name:JENKIN, CAROL R (LMT)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:R
Last Name:JENKIN
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 1:5638 N COPLAY RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-3443
Mailing Address - Country:US
Mailing Address - Phone:484-747-7702
Mailing Address - Fax:
Practice Address - Street 1:5638 N COPLAY RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-3443
Practice Address - Country:US
Practice Address - Phone:484-747-7702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG001445225700000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist