Provider Demographics
NPI:1770741167
Name:BURGE, JENNIFER LYNNE (PT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:BURGE
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:4911 SW 19TH STREET
Mailing Address - Street 2:FLEUR HEIGHTS CENTER FOR WELLNESS AND REHABILITATION
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315
Mailing Address - Country:US
Mailing Address - Phone:515-285-2559
Mailing Address - Fax:515-256-4155
Practice Address - Street 1:4911 SW 19TH STREET
Practice Address - Street 2:FLEUR HEIGHTS CENTER FOR WELLNESS AND REHABILITATION
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315
Practice Address - Country:US
Practice Address - Phone:515-285-2559
Practice Address - Fax:515-256-4155
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA02974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist