MEDICARE: JENNA VALAER 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	PTH6344	AL

General Provider Information

NPI Number	:	1225475197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA VALAER DPT

Provider Business Mailing Address
First Line	:	2470 ROCKY RIDGE RD
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2833
Country	:	US
Telephone Number	:	205-824-4525
Fax Number	:	205-823-6051

Provider Business Practice Location Address
First Line	:	2470 ROCKY RIDGE RD
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2833
Country	:	US
Telephone Number	:	205-824-4525
Fax Number	:	205-823-6051

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

Provider Enumeration Date	:	05/31/2013
Last Update Date	:	05/31/2013

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