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General NPI Number Information
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NPI Number | 1144693268
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Entity Type | Individual
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Provider Name | JESSICA GLOVER DPT
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Gender | Female
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 10000 BAY PINES BLVD BUILDING 101 ROOM B2
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City | BAY PINES
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State | FL
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Zip | 33744-8200
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Country | US
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Telephone | 727-398-9366
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Fax |
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Provider Business Mailing Address
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Address Line | 7532 71ST AVE N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3784
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Country | US
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Telephone | 614-917-3097
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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 | PT 26594
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License Number State | FL
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