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General NPI Number Information
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NPI Number | 1750672986
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Entity Type | Individual
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Provider Name | JESSICA ENSOR
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Gender | Female
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 2222 SPRINGDALE RD
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City | CINCINNATI
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State | OH
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Zip | 45231-1805
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Country | US
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Telephone | 740-442-1412
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Fax |
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Provider Business Mailing Address
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Address Line | 466 TOWNSHIP ROAD 248 W
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City | KITTS HILL
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State | OH
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Zip | 45645-9069
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Country | US
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Telephone | 740-442-1412
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA.07821
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License Number State | OH
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