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NPI Code Detail

MEDICARE: JESSICA L EDDY DPT

MEDICARE: JESSICA L EDDY 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
1225100000XPhysical Therapist19591MA

General Provider Information

NPI Number : 1215640982
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA L EDDY DPT
Provider Business Mailing Address
First Line : 39 JACOBY AVE
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-5820
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 24 PARK ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-0900
Country : US
Telephone Number : 413-629-1919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2022
Last Update Date : 12/27/2022

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Directions to “ JESSICA L EDDY DPT” Practice Location

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