Healthcare Provider Details

I. General information

NPI: 1841502911
Provider Name (Legal Business Name): JESSICA DOBBS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 N COALTER ST
STAUNTON VA
24401-2552
US

IV. Provider business mailing address

1609 N COALTER ST
STAUNTON VA
24401-2552
US

V. Phone/Fax

Practice location:
  • Phone: 540-213-1320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2305206512
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: