MEDICARE: DR. JESSICA JANE WEST PT, 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	1294086	TX

General Provider Information

NPI Number	:	1700514262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA JANE WEST PT, DPT

Provider Business Mailing Address
First Line	:	2817 S MAYHILL RD STE 120
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-5967
Country	:	US
Telephone Number	:	940-252-8070
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 S MAYHILL RD STE 120
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-5967
Country	:	US
Telephone Number	:	940-252-8070
Fax Number	:

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

Provider Enumeration Date	:	08/11/2022
Last Update Date	:	09/26/2022

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