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General NPI Number Information
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NPI Number | 1740669241
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Entity Type | Individual
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Provider Name | JENNIFER ELIAS BERTOLUZZI D.P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 606 E MAIN ST
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4492
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Country | US
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Telephone | 765-761-2141
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Fax |
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Provider Business Mailing Address
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Address Line | 116 WILLIAM DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-9457
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Country | US
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Telephone | 401-714-2627
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Fax |
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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 | P24181
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License Number State | NC
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