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General NPI Number Information
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NPI Number | 1194034009
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Entity Type | Individual
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Provider Name | JENNIFER ODEAN JENKINS PT
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Gender | Female
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 6301 SMITH DIAMOND RD
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City | EVANSVILLE
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State | IN
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Zip | 47712-8914
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Country | US
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Telephone | 812-746-7728
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Fax |
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Provider Business Mailing Address
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Address Line | 6301 SMITH DIAMOND RD
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City | EVANSVILLE
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State | IN
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Zip | 47712-8914
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Country | US
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Telephone | 812-746-7728
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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 | 05011742A
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License Number State | IN
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