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NPI Code Detail

MEDICARE: SHARON C JENNINGS PT

MEDICARE:   SHARON C JENNINGS  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 Therapist7540AZ

General Provider Information

NPI Number : 1386790178
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON C JENNINGS PT
Provider Business Mailing Address
First Line : 10822 W RIO VISTA LN
Second Line :
City : AVONDALE
State : AZ
Zip : 85323-1160
Country : US
Telephone Number : 623-792-7310
Fax Number :
Provider Business Practice Location Address
First Line : 2400 W DUNLAP AVE
Second Line : STE 145
City : PHOENIX
State : AZ
Zip : 85021-2817
Country : US
Telephone Number : 602-870-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 07/08/2007

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Directions to “ SHARON C JENNINGS PT” Practice Location

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