MEDICARE: JACQUELYN F RINALDO P.T.

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	000332	KY

General Provider Information

NPI Number	:	1992909519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELYN F RINALDO P.T.

Provider Business Mailing Address
First Line	:	PO BOX 4507
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47724-0507
Country	:	US
Telephone Number	:	812-471-8630
Fax Number	:	812-471-8640

Provider Business Practice Location Address
First Line	:	3600 FREDERICA ST
Second Line	:	SUITE A
City	:	OWENSBORO
State	:	KY
Zip	:	42301-6981
Country	:	US
Telephone Number	:	270-926-1774
Fax Number	:

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

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	07/08/2007

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