Provider Demographics
NPI:1255795746
Name:LIPPENS, JESSICA LEE (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:LIPPENS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3290 RIDGEWAY DR STE 3
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2023
Mailing Address - Country:US
Mailing Address - Phone:319-665-2630
Mailing Address - Fax:319-665-2631
Practice Address - Street 1:762 N CENTER POINT RD
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1226
Practice Address - Country:US
Practice Address - Phone:319-294-6717
Practice Address - Fax:319-363-2903
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA005173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist