Healthcare Provider Details

I. General information

NPI: 1285769877
Provider Name (Legal Business Name): JENNIFER N. WUNDERLICH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER N. BRAUER PT

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 N BEND RD STE 600
HEBRON KY
41048-8003
US

IV. Provider business mailing address

2010 N BEND RD STE 600
HEBRON KY
41048-8003
US

V. Phone/Fax

Practice location:
  • Phone: 859-594-5220
  • Fax:
Mailing address:
  • Phone: 859-594-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007035
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: