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General NPI Number Information
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NPI Number | 1427561521
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Entity Type | Individual
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Provider Name | JESSICA ANN NEWCOMER PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/10/2017
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 4026F ELKHART RD
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City | GOSHEN
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State | IN
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Zip | 46526-5795
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Country | US
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Telephone | 574-501-3222
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Fax | 574-346-0169
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Provider Business Mailing Address
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Address Line | 2122 YORK RD STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523-1925
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Country | US
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Telephone | 630-575-1980
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Fax | 630-928-5080
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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 | PT013354
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License Number State | GA
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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 | PTH8812
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License Number State | AL
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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 | 2017043057
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License Number State | MO
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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 | PT33173
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License Number State | FL
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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 | 05013172A
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License Number State | IN
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