Provider Demographics
NPI:1245510916
Name:JESSICA SCHNELL PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:JESSICA SCHNELL PHYSICAL THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SCHNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:340-514-2376
Mailing Address - Street 1:5000 ESTATE ENIGHED
Mailing Address - Street 2:PMB 535
Mailing Address - City:ST JOHN
Mailing Address - State:VI
Mailing Address - Zip Code:00830-6120
Mailing Address - Country:US
Mailing Address - Phone:340-642-5602
Mailing Address - Fax:800-403-8365
Practice Address - Street 1:4 ENIGHED, SUITE #104
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:VI
Practice Address - Zip Code:00830
Practice Address - Country:US
Practice Address - Phone:340-514-2376
Practice Address - Fax:800-403-8365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI153261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy