Provider Demographics
NPI:1851455810
Name:COLE, JENNIFER (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMPTON ROAD, SUITE 205
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4848
Mailing Address - Country:US
Mailing Address - Phone:603-772-0604
Mailing Address - Fax:603-772-9993
Practice Address - Street 1:1 HAMPTON RD UNIT 205
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4855
Practice Address - Country:US
Practice Address - Phone:603-772-0604
Practice Address - Fax:603-772-9993
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
0185659OtherCIGNA
08Y003041NH01OtherANTHEM BC-BS
08Y003041NH01OtherANTHEM BC-BS