Individual
MRS. JESSICA SUE KINNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
601 OH - 664N, LOGAN, OH 43138
(740) 380-8233
(740) 385-7458
Mailing address
601 OH - 664N, PO BOX 966, LOGAN, OH 43138
(740) 380-8233
(740) 385-7458
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
013324
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3978503
—
OH
Enumeration date
10/02/2024
Last updated
10/02/2024
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