Jennifer Jo McDonald
Individual provider Active NPI Physical Therapy Assistant · Brewster, OH
NPI 1063976017 · NPPES record last updated Jan 30, 2019
Key facts
- NPI
- 1063976017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 09623 (OH)
- Practice address
- 360 Wabash Ave N
Brewster, OH 44613-1042 - Phone
- (330) 767-4179
- NPI assigned
- Jan 23, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09623 | OH | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 09623 | OH | Yes |
Addresses
Primary practice location
360 Wabash Ave N
Brewster, OH 44613-1042
Mailing address
2220 University Dr SE
Massillon, OH 44646-7443
Phone (330) 316-9170
Other providers in Brewster, OH
- Morgen Durant
- Judy Grubb
- Krystal Hewitt
- K C Health Services
- K-C Health Services Inc
- Taryn Renee Shackle
- Patrick Smith
- Tyler Tull
- Vyctoria Turner
- Village of Brewster
All providers in Brewster, OH · Physical Therapy Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.