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NPI Code Detail

MEDICARE: MRS. JENNIFER ADELE ST. GEORGE PT

MEDICARE:  MRS. JENNIFER ADELE ST. GEORGE  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
1225100000XPhysical TherapistPT016524PA

General Provider Information

NPI Number : 1063629442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER ADELE ST. GEORGE PT
Provider Business Mailing Address
First Line : 559 CREEKSIDE DR
Second Line :
City : SOUDERTON
State : PA
Zip : 18964-2265
Country : US
Telephone Number : 267-382-0209
Fax Number :
Provider Business Practice Location Address
First Line : 1001 EASTON RD
Second Line : 101 MANOR
City : WILLOW GROVE
State : PA
Zip : 19090-2028
Country : US
Telephone Number : 215-659-7759
Fax Number : 215-659-6658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. JENNIFER ADELE ST. GEORGE PT” Practice Location

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