MEDICARE: MRS. JENNIFER JO MCLAUGHLIN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2013028650	MO

General Provider Information

NPI Number	:	1053743633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER JO MCLAUGHLIN DPT

Provider Business Mailing Address
First Line	:	6264 LEWIS DR
Second Line	:
City	:	PARKVILLE
State	:	MO
Zip	:	64152-3603
Country	:	US
Telephone Number	:	816-587-8001
Fax Number	:	816-587-8907

Provider Business Practice Location Address
First Line	:	6264 LEWIS DR
Second Line	:
City	:	PARKVILLE
State	:	MO
Zip	:	64152-3603
Country	:	US
Telephone Number	:	816-587-8001
Fax Number	:	816-587-8907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	03/21/2023

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