Individual
JENNIFER LYNN DENISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4100
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005551A
IN
Other
Enumeration date
08/03/2017
Last updated
07/27/2023
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