Individual
JENNY LYNN PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1201 CUMBERLAND XING, VALPARAISO, IN 46383-2192
(219) 286-3890
Mailing address
263 S SR 49, VALPARAISO, IN 46383-9790
(219) 309-5461
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011733A
IN
225100000X
Physical Therapist
12214-24
WI
225100000X
Physical Therapist
PT.014010
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714850269
—
IN
Enumeration date
10/29/2012
Last updated
12/09/2019
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