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Individual

JENNIFER L. MIDKIFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
313 MACCORKLE AVE SW, CHARLESTON, WV 25303-1263
(304) 744-2300
(304) 744-8195
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(304) 744-2300
(304) 744-8195

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001163
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000216606
OH MEDICAID UNISON
OH
01
000000217253
ANTHEM BCBS
01
000646536
MOUNTAIN STATE BCBS
05
0157388000
WV
05
2229010
OH
01
650019721
RR MEDICARE
Enumeration date
07/14/2006
Last updated
10/24/2011
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