Provider Demographics
NPI:1356783948
Name:BENDELE, JESSICA LYNN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYNN
Last Name:BENDELE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:BRINKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:23811 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5525
Mailing Address - Country:US
Mailing Address - Phone:216-682-0413
Mailing Address - Fax:216-862-0417
Practice Address - Street 1:23811 CHAGRIN BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5525
Practice Address - Country:US
Practice Address - Phone:216-682-0413
Practice Address - Fax:216-862-0417
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.014386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH247010Medicare PIN