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General NPI Number Information
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NPI Number | 1316607120
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Entity Type | Individual
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Provider Name | JESSICA GRABOWSKI DPT
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Gender | Female
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Dates
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Enumeration Date | 12/20/2021
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 203 GREEN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19123-2945
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Country | US
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Telephone | 215-925-2339
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Fax |
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Provider Business Mailing Address
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Address Line | 5508 S WOODCLIFFE DR
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City | SPRINGFIELD
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State | MO
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Zip | 65804-5315
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Country | US
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Telephone | 773-504-1014
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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 | 11-07148
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License Number State | KS
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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 | 2021031363
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 301528
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP008742T
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT031243
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License Number State | PA
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