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General NPI Number Information
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NPI Number | 1962397687
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Entity Type | Individual
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Provider Name | JENNIFER W PAA PT
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Gender | Female
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 4443 JESSUP GROVE RD
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City | GREENSBORO
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State | NC
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Zip | 27410-9934
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Country | US
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Telephone | 336-663-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 402 CRESTLAND AVE
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City | GREENSBORO
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State | NC
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Zip | 27401
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Country | US
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Telephone | 336-392-5030
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 10974
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License Number State | NC
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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 | P10974
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License Number State | NC
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