Provider Demographics
NPI:1295146066
Name:COBB, JENNIFER M (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:COBB
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 VESTAL PKWY E STE 10
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1966
Mailing Address - Country:US
Mailing Address - Phone:607-444-3151
Mailing Address - Fax:607-444-3072
Practice Address - Street 1:1901 VESTAL PKWY E STE 10
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1966
Practice Address - Country:US
Practice Address - Phone:607-444-3151
Practice Address - Fax:607-444-3072
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist