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General NPI Number Information
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NPI Number | 1710075932
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Entity Type | Individual
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Provider Name | JENNIFER ZEOLLA FRICK MPT
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 1601 UNION AVENUE, PLAZA ONE SUITE D
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City | NATRONA HEIGHTS
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State | PA
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Zip | 15065
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Country | US
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Telephone | 724-224-5090
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Fax | 724-224-5093
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Provider Business Mailing Address
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Address Line | 430 INNOVATION DRIVE
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City | BLAIRSVILLE
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State | PA
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Zip | 15717-8096
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Country | US
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Telephone | 724-343-4060
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Fax | 724-343-4069
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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 | PT007899L
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License Number State | PA
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