Doctor Name: | MRS. JENNIFER LYNN VAN BUSSEL |
NPI Number: | 1063692309 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BSC. PT |
License Number: | PT 23690 |
Business Practice Address: | 3901 University Blvd S Jacksonville, FL - 322164312 |
Business Phone Number: | 9048587200 |
Business Fax Number: | 9048587240 |
Mailing Address: | 10435 Midtown Pkwy Unit 129, JACKSONVILLE |
State: | FL |
Postal Code: | 322467463 |
Phone Number: | 9046417966 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2007 |
NPI Last Update Date: | 11/04/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 23690 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |