Basic Information
| Provider Information | |||||||||
| NPI: | 1578928891 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEERE | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KELLY | ||||||||
| OtherFirstName: | JENNIFER | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 670 LINWOOD AVE | ||||||||
| Address2: | STE 2 | ||||||||
| City: | WHITINSVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015882068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082347544 | ||||||||
| FaxNumber: | 5082348002 | ||||||||
| Practice Location | |||||||||
| Address1: | 670 LINWOOD AVE | ||||||||
| Address2: | STE 2 | ||||||||
| City: | WHITINSVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015882068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082347544 | ||||||||
| FaxNumber: | 5082348002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2015 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 22060 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.