Healthcare Provider Details

I. General information

NPI: 1538602172
Provider Name (Legal Business Name): JESSICA A UREY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 OLENTANGY RIVER RD STE 260
COLUMBUS OH
43214-3467
US

IV. Provider business mailing address

3705 OLENTANGY RIVER RD STE 260
COLUMBUS OH
43214-3467
US

V. Phone/Fax

Practice location:
  • Phone: 614-533-6600
  • Fax: 614-533-6609
Mailing address:
  • Phone: 614-533-6600
  • Fax: 614-533-6609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT013768
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: