Basic Information
| Provider Information | |||||||||
| NPI: | 1356548762 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASEY | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8718 PAULDEN CT | ||||||||
| Address2: | |||||||||
| City: | LEWIS CENTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430357946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148467860 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2270 WARRENSBURG RD | ||||||||
| Address2: | |||||||||
| City: | DELAWARE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430151336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403699614 | ||||||||
| FaxNumber: | 7403635881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 10668 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.