Individual
JENNIFER N DISNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05004574
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200482180
—
IN
01
—
P00861448
RAILROAD MEDICARE
IN
Enumeration date
06/16/2005
Last updated
04/08/2011
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