Provider Demographics
NPI:1811014863
Name:BITTLE, JESSICA LEE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LEE
Last Name:BITTLE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SHARON DR
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304-4325
Mailing Address - Country:US
Mailing Address - Phone:603-491-0661
Mailing Address - Fax:
Practice Address - Street 1:7 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2000
Practice Address - Country:US
Practice Address - Phone:603-934-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist