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General NPI Number Information
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NPI Number | 1124199260
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Entity Type | Individual
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Provider Name | JENNIFER M HYDE MSPT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9097 ATLEE STATION RD SUITE 303
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2525
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Country | US
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Telephone | 804-559-3390
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Fax | 804-559-3514
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Provider Business Mailing Address
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Address Line | 10328 BERKELEY MANOR DR
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-5132
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Country | US
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Telephone | 804-550-0971
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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 | 2305202826
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License Number State | VA
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