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Individual

KATHLEEN BRIDGET JEDLOVEC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSPT MSTS PCS

Contact information

Practice address
2075 MAX LUTHER DRIVE, HUNTSVILLE, AL 35810-3859
(256) 852-5600
(256) 852-6722
Mailing address
15007 COLLIER DRIVE, HUNTSVILLE, AL 35803-3689
(256) 880-3263

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH686
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51511224
BLUE CROSS BLUE SHIELD
Enumeration date
11/07/2006
Last updated
07/08/2007
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