Provider Demographics
NPI:1972817823
Name:PRICE, JENNIFER LEE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEE
Last Name:PRICE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4880 N SHERMAN STREET EXT
Mailing Address - Street 2:
Mailing Address - City:MOUNT WOLF
Mailing Address - State:PA
Mailing Address - Zip Code:17347-9637
Mailing Address - Country:US
Mailing Address - Phone:717-266-9294
Mailing Address - Fax:717-384-8071
Practice Address - Street 1:4880 N SHERMAN STREET EXT
Practice Address - Street 2:
Practice Address - City:MOUNT WOLF
Practice Address - State:PA
Practice Address - Zip Code:17347-9637
Practice Address - Country:US
Practice Address - Phone:717-266-9294
Practice Address - Fax:717-384-8071
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist