Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 40QA00430400 | NJ |
Y | 2251G0304X | Physical Therapist - Geriatrics | PT019541 | PA |
NPI | 1164648234 |
---|---|
Provider Name | Jennifer Frances Stover |
First Address | Downingtown, PA 19335-4544 |
Second Address | Narvon, PA 17555-9328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 10/06/2009 |