Provider Demographics
NPI:1790964559
Name:UHLENBERG, JENNIFER KISTLER (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KISTLER
Last Name:UHLENBERG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2701 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-3669
Mailing Address - Country:US
Mailing Address - Phone:336-375-4263
Mailing Address - Fax:336-375-4262
Practice Address - Street 1:1130 N CHURCH ST STE 201
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1041
Practice Address - Country:US
Practice Address - Phone:336-275-2285
Practice Address - Fax:336-275-2286
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist