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General NPI Number Information
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NPI Number | 1598932113
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Entity Type | Organization
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Legal Business Name | JROSE INTEGRATIVE THERAPY
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 900 STANHOPE GARDENS SUITE 101
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City | CHESAPEAKE
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State | VA
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Zip | 23320
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Country | US
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Telephone | 757-842-6562
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Fax | 757-842-6563
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Provider Business Mailing Address
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Address Line | 900 STANHOPE GARDENS SUITE 101
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City | CHESAPEAKE
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State | VA
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Zip | 23320
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Country | US
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Telephone | 757-842-6562
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Fax | 757-842-6563
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MS. JENNIFER R WATSON
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Credential | M.P.T.
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Telephone | 757-842-6562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2305202961
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License Number State | VA
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