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General NPI Number Information
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NPI Number | 1306259593
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Entity Type | Individual
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Provider Name | JENNA YORK PT, DPT, CSCS
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Gender | Female
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 103 BASTIANI DR
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1604
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Country | US
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Telephone | 330-727-2142
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Fax |
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Provider Business Mailing Address
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Address Line | 3924 LOWER ELKTON RD
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City | LEETONIA
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State | OH
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Zip | 44431-8629
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Country | US
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Telephone | 330-727-2142
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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 | 2305207195
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 013109
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License Number State | OH
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