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General NPI Number Information
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NPI Number | 1033807664
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Entity Type | Individual
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Provider Name | JESSICA ELAINE BLUBAUGH PT, DPT, FMT, EIS
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Gender | Female
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 6125 INWOOD DR
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City | COLUMBUS
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State | IN
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Zip | 47201-5698
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Country | US
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Telephone | 317-419-0372
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Fax | 812-379-8047
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Provider Business Mailing Address
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Address Line | 6125 INWOOD DR
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City | COLUMBUS
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State | IN
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Zip | 47201-5698
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Country | US
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Telephone | 317-419-0372
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT018939
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05013976A
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License Number State | IN
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