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General NPI Number Information
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NPI Number | 1265596407
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Entity Type | Individual
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Provider Name | JENNIFER MICHELE MENKE PT
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Gender | Female
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 15 TOWN WEST RD
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City | PLYMOUTH
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State | NH
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Zip | 03264-3428
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Country | US
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Telephone | 603-536-2941
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 715
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City | NEW HAMPTON
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State | NH
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Zip | 03256-0715
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Country | US
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Telephone | 603-677-3985
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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 | 3187
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License Number State | NH
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