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NPI Code Detail

MEDICARE: DR. JENNIFER RENEE KIN PT

MEDICARE: DR. JENNIFER RENEE KIN PT
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
1225100000XPhysical Therapist011565OH

General Provider Information

NPI Number : 1063620805
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER RENEE KIN PT
Provider Business Mailing Address
First Line : 4220 GEIGER RD
Second Line :
City : MILLERSPORT
State : OH
Zip : 43046-9530
Country : US
Telephone Number : 567-232-0853
Fax Number :
Provider Business Practice Location Address
First Line : 5500 E BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1476
Country : US
Telephone Number : 614-575-9003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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