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General NPI Number Information
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NPI Number | 1356481816
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Entity Type | Individual
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Provider Name | JENNIFER LYNN NUS D.P.T.
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2109 CEDARWOOD DR SUITE 100
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City | MUSCATINE
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State | IA
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Zip | 52761-2661
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Country | US
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Telephone | 562-388-6787
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Fax |
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Provider Business Mailing Address
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Address Line | 3106 155TH ST
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City | MUSCATINE
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State | IA
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Zip | 52761-9736
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Country | US
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Telephone | 319-269-1619
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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 | 04004
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License Number State | IA
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