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General NPI Number Information
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NPI Number | 1245788702
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Entity Type | Individual
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Provider Name | JENNIFER DEMJANENKO DPT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 7300 DEARWESTER DR
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City | CINCINNATI
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State | OH
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Zip | 45236-6119
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Country | US
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Telephone | 614-202-5315
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Fax |
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Provider Business Mailing Address
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Address Line | 2860 OBSERVATORY AVE APT 13
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City | CINCINNATI
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State | OH
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Zip | 45208-2359
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Country | US
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Telephone | 614-202-5315
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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 | PT016529
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License Number State | OH
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