MEDICARE: JESSICA DURBIN DPT

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	PT017310	OH

General Provider Information

NPI Number	:	1154822724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA DURBIN DPT

Provider Business Mailing Address
First Line	:	4494 FORESTHILL RD
Second Line	:
City	:	STOW
State	:	OH
Zip	:	44224-1953
Country	:	US
Telephone Number	:	330-819-0876
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 MEDINA RD UNIT N
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-2424
Country	:	US
Telephone Number	:	330-625-5549
Fax Number	:

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

Provider Enumeration Date	:	02/28/2018
Last Update Date	:	07/25/2021

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