Provider Demographics
NPI:1740525625
Name:RAYMOND, JENNIFER ANN (DPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 NEW LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-4958
Mailing Address - Country:US
Mailing Address - Phone:978-840-1900
Mailing Address - Fax:789-840-1263
Practice Address - Street 1:225 NEW LANCASTER RD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-840-1900
Practice Address - Fax:789-840-1263
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist