Individual
JENNIFER ANN HAWKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1032 SE LANE AVE, ROSEBURG, OR 97470-3956
(541) 784-7771
(205) 905-6010
Mailing address
428 OAKVIEW DR, ROSEBURG, OR 97471-9519
(541) 784-7771
(541) 672-1466
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3533
OR
225700000X
Massage Therapist
13630
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396130894
GROUP NPI
OR
Enumeration date
08/11/2009
Last updated
06/11/2023
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