# JENMITOLPT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407669617
- **Authorized official:** DR. JENNIFER MITOL PT (OWNER)
- **Authorized official phone:** (773) 368-8682

## Contact information

- **Practice address:** 61859 AVONLEA CIR, BEND, OR 97702-9345
- **Practice address phone:** (773) 368-8682
- **Mailing address:** 61859 AVONLEA CIR, BEND, OR 97702-9345
- **Mailing address phone:** (773) 368-8682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/30/2025
- **Last updated:** 01/30/2025