Provider Demographics
NPI:1740436443
Name:WILSON, JENNIFER PUFF (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PUFF
Last Name:WILSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:1403 MILL RACE DRIVE
Mailing Address - Street 2:HEARTLAND REHABILITATION SERVICES INC.
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153
Mailing Address - Country:US
Mailing Address - Phone:540-444-5126
Mailing Address - Fax:540-444-0531
Practice Address - Street 1:6515 WILLIAMSON ROAD
Practice Address - Street 2:HEARTLAND REHABILITATION SERVICES INC.
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24109
Practice Address - Country:US
Practice Address - Phone:540-366-2243
Practice Address - Fax:540-366-4801
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
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Provider Licenses
StateLicense IDTaxonomies
VA2305203377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist