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General NPI Number Information
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NPI Number | 1457414609
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Entity Type | Individual
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Provider Name | JENNIFER A SKEESICK DPT, SCS
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 103 N MAIN ST STE 99
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City | GREENVILLE
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State | SC
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Zip | 29601-2796
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Country | US
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Telephone | 864-528-5728
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 LOMBARD LOOP RD
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City | WAPATO
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State | WA
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Zip | 98951-9685
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Country | US
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Telephone | 334-750-9174
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Fax | 864-528-5701
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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 | 11773
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License Number State | NC
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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 | 6348
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License Number State | SC
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