Individual
MRS. JENIFER LEE FURNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR, COF
Contact information
Practice address
2123 LILLIE AVE, DAVENPORT, IA 52804-2040
(563) 343-0852
Mailing address
2123 LILLIE AVE, DAVENPORT, IA 52804-2040
(563) 343-0852
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
225X00000X
Occupational Therapist
01130
IA
225X00000X
Occupational Therapist
056.004970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264560645
—
IL
05
—
3053065
—
OH
05
—
7100120570
—
KY
Enumeration date
03/28/2007
Last updated
05/03/2011
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