Basic Information
| Provider Information | |||||||||
| NPI: | 1013361088 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAPMAN | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | COLE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | COLE | ||||||||
| OtherFirstName: | JENNIFER | ||||||||
| OtherMiddleName: | MCCRACKEN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | PT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 518 SUNSHINE LN | ||||||||
| Address2: | |||||||||
| City: | KIMPER | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415396449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066313174 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 60 PHILLIPS BRANCH RD | ||||||||
| Address2: | |||||||||
| City: | PHELPS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415539061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064568725 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2016 | ||||||||
| LastUpdateDate: | 04/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 004971 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.