Individual
JESSICA STIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1700 LINDBERG RD, WEST LAFAYETTE, IN 47906-7317
(765) 464-5600
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 446-5417
(765) 446-5317
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011261A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300033967
—
IN
Enumeration date
12/13/2019
Last updated
05/09/2022
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