Provider Demographics
NPI:1801868690
Name:FRITTS, JENNIFER J (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:FRITTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:435 HARTFORD TPKE
Mailing Address - Street 2:SUITE U
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4852
Mailing Address - Country:US
Mailing Address - Phone:860-979-1611
Mailing Address - Fax:203-866-3014
Practice Address - Street 1:12 MAIN ST
Practice Address - Street 2:SUITE 7
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3339
Practice Address - Country:US
Practice Address - Phone:860-872-7500
Practice Address - Fax:860-872-7501
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2016-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT007496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650000996Medicare ID - Type Unspecified