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General NPI Number Information
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NPI Number | 1710209689
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Entity Type | Organization
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Legal Business Name | JUMP START PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 38043 WINDY RIDGE TRL
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City | MAGNOLIA
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State | TX
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Zip | 77355
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Country | US
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Telephone | 832-656-7660
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Fax | 832-559-7720
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Provider Business Mailing Address
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Address Line | 38043 WINDY RIDGE TRL
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City | MAGNOLIA
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State | TX
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Zip | 77355
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Country | US
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Telephone | 832-656-7660
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Fax | 832-559-7720
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Authorized Official
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Title or Position | OWNER, PT
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Name | WENDY M GIBBS
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Credential | PT
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Telephone | 832-656-7660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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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 |
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License Number State |
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