Doctor Name: | JENNA ZEMLOCK |
NPI Number: | 1003263922 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 801 Howard Ave Altoona, PA - 166014727 |
Business Phone Number: | 8148893600 |
Business Fax Number: | |
Mailing Address: | 811 Philadelphia Ave, NORTHERN CAMBRIA |
State: | PA |
Postal Code: | 157141334 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/20/2016 |
NPI Last Update Date: | 05/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |