Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT014578 | OH |
N | 2251S0007X | Physical Therapist - Sports | PT014578 | OH |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT014578 | OH |
NPI | 1235600859 |
---|---|
Provider Name | Neola Jenkins |
First Address | West Chester, OH 45069 |
Second Address | Centerville, OH 45459-4044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2018 |
Last Update Date | 07/12/2018 |