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NPI Code Detail

MEDICARE: JENNIFER NICOLE CROOKS

MEDICARE: JENNIFER NICOLE CROOKS
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 Therapist117715MO
2225100000XPhysical Therapist11-02694KS

General Provider Information

NPI Number : 1790825404
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER NICOLE CROOKS
Provider Business Mailing Address
First Line : 1402 TABITHA LN
Second Line :
City : GREENWOOD
State : MO
Zip : 64034-9220
Country : US
Telephone Number : 816-537-4553
Fax Number : 816-537-4542
Provider Business Practice Location Address
First Line : 2133 NW 13TH ST
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64015-7734
Country : US
Telephone Number : 816-224-0003
Fax Number : 816-224-2199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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Directions to “ JENNIFER NICOLE CROOKS ” Practice Location

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