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1750603536 NPI number — JESSICA A COLFLESH DPT

NPI Number: 1750603536
Health Care Provider/Practitioner: JESSICA A COLFLESH DPT

Information about “1750603536” NPI (JESSICA A COLFLESH DPT) exists in 1750603536 in HTML format HTML  |  1750603536 in plain Text format TXT  |  1750603536 in PDF (Portable Document Format) PDF  |  1750603536 in an XML format XML  formats.

NPI Number : 1750603536 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750603536",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COLFLESH",
    "FirstName": "JESSICA",
    "MiddleName": "A",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KENDZIORSKI",
    "OtherFirstName": "JESSICA",
    "OtherMiddleName": "A",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "110 MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WINTERSVILLE",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43953-3734",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "740-266-6855",
    "MailingAddressFaxNumber": "740-264-4376",
    "FirstLinePracticeLocationAddress": "115 MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WINTERSVILLE",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43953-3733",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "740-266-6855",
    "PracticeLocationAddressFaxNumber": "740-264-4376",
    "EnumerationDate": "02/22/2010",
    "LastUpdateDate": "01/04/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "PT012306",
        "LicenseNumberStateCode": "OH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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