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General NPI Number Information
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NPI Number | 1518526102
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Entity Type | Individual
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Provider Name | HAILEY DAWN JAHNEL DPT
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Gender | Female
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 24007 BUSINESS HIGHWAY 71
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City | MARYVILLE
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State | MO
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Zip | 64468-8235
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Country | US
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Telephone | 660-235-0002
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Fax | 660-224-0108
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Provider Business Mailing Address
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Address Line | 24007 BUSINESS HIGHWAY 71
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City | MARYVILLE
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State | MO
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Zip | 64468-8235
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Country | US
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Telephone | 660-235-0002
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Fax | 660-224-0108
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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 | 11-06127
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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 | 03485
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License Number State | NE
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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 | 11-06122
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License Number State | MO
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