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General NPI Number Information
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NPI Number | 1053014100
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Entity Type | Individual
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Provider Name | JEENA GEORGE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 1434 W US HIGHWAY 287 BYP STE 200
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City | WAXAHACHIE
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State | TX
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Zip | 75165-5007
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Country | US
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Telephone | 469-553-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 5936 MAIN ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-3365
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Country | US
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Telephone | 847-440-6570
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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 | 070027104
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License Number State | IL
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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 | 1401418
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License Number State | TX
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