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NPI Code Detail

MEDICARE: DR. JESSICA ELAINE BLUBAUGH PT, DPT, FMT, EIS

MEDICARE: DR. JESSICA ELAINE BLUBAUGH PT, DPT, FMT, EIS
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
1225100000XPhysical TherapistPT018939OH
2225100000XPhysical Therapist05013976AIN

General Provider Information

NPI Number : 1033807664
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA ELAINE BLUBAUGH PT, DPT, FMT, EIS
Provider Business Mailing Address
First Line : 6125 INWOOD DR
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-5698
Country : US
Telephone Number : 317-419-0372
Fax Number :
Provider Business Practice Location Address
First Line : 6125 INWOOD DR
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-5698
Country : US
Telephone Number : 317-419-0372
Fax Number : 812-379-8047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2023
Last Update Date : 05/01/2023

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