Healthcare Provider Details

I. General information

NPI: 1275715385
Provider Name (Legal Business Name): JENNIFER A SPINELLI MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER A ONARECKER MPT

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6904 E RENO AVE
MIDWEST CITY OK
73110-2152
US

IV. Provider business mailing address

825 N BROADWAY AVE SUITE 400
OKLAHOMA CITY OK
73102-6039
US

V. Phone/Fax

Practice location:
  • Phone: 405-610-2488
  • Fax: 405-610-2484
Mailing address:
  • Phone: 405-609-3670
  • Fax: 405-605-8638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT019048
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: