MEDICARE: JENNIFER LINN GODOWN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	12341	CA

General Provider Information

NPI Number	:	1033249644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LINN GODOWN PT

Provider Business Mailing Address
First Line	:	20330 VIA MANZANILLO
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92887-3264
Country	:	US
Telephone Number	:	714-504-6777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1075 YORBA PL STE 107
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3109
Country	:	US
Telephone Number	:	714-524-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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Directions to “ JENNIFER LINN GODOWN PT” Practice Location

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