Individual
JENNIFER R DENNISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
315 E LONDON GROVE RD, WEST GROVE, PA 19390-9239
(610) 869-2456
Mailing address
315 E LONDON GROVE RD, WEST GROVE, PA 19390-9239
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT022522
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT022522
STATE LICENSE
PA
Enumeration date
06/27/2017
Last updated
06/16/2018
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