MEDICARE: JENNA GOAR 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

General Provider Information

NPI Number	:	1982112611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA GOAR DPT

Provider Business Mailing Address
First Line	:	397 ABBOTSBURY DR
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-9121
Country	:	US
Telephone Number	:	720-937-1174
Fax Number	:

Provider Business Practice Location Address
First Line	:	6573 E BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1509
Country	:	US
Telephone Number	:	614-655-1165
Fax Number	:	937-230-9986

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

Provider Enumeration Date	:	01/16/2018
Last Update Date	:	10/05/2022

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Directions to “ JENNA GOAR DPT” Practice Location

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