Individual
JENNIFER ELLEN ABBOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1248 COLUMBUS AVE, LEBANON, OH 45036-8363
(513) 932-2273
(513) 932-1644
Mailing address
1110 E MAIN ST APT 403, LEBANON, OH 45036-6446
(513) 933-0497
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33 016551 A-B
STATE MEDICAL BOARD
OH
Enumeration date
11/11/2009
Last updated
11/11/2009
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