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General NPI Number Information
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NPI Number | 1306661962
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Entity Type | Individual
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Provider Name | JENNYFER MACIEL FORD DPT
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | LINA-PFAFF-STRASSE 2
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City | KAISERSLAUTERN
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State | RHINELAND-PALATINATE
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Zip | 67655
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Country | DE
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Telephone | 175-400-0348
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 402 BOX 1429
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City | APO
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State | AE
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Zip | 09180-0024
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Country | US
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Telephone | 175-400-0348
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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 | PT017127
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License Number State | GA
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