Healthcare Provider Details

I. General information

NPI: 1720732050
Provider Name (Legal Business Name): JENNIFER FREEMAN DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 EASTON RD STE 207
WYNCOTE PA
19095-2900
US

IV. Provider business mailing address

4265 MINNIE LN
HATBORO PA
19040-2510
US

V. Phone/Fax

Practice location:
  • Phone: 215-517-7551
  • Fax:
Mailing address:
  • Phone: 215-429-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT030167
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: