Provider Demographics
NPI:1003121088
Name:CLARKSON, JENNIFER LYNNETTE (DPT, L/CNMT)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNNETTE
Last Name:CLARKSON
Suffix:
Gender:F
Credentials:DPT, L/CNMT
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Mailing Address - Street 1:1328 STOEBER AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2138
Mailing Address - Country:US
Mailing Address - Phone:941-350-2465
Mailing Address - Fax:941-351-5848
Practice Address - Street 1:3920 BEE RIDGE RD
Practice Address - Street 2:BLDG E, UNIT G
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-925-2700
Practice Address - Fax:941-925-7744
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2015-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLMA40447225700000X
FLPT30667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist