| Doctor Name: | MRS. JENNIFER IRENE DICKINSON |
| NPI Number: | 1134165202 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | PT2782 |
| Business Practice Address: | 9848 N Tryon St Charlotte, NC - 282625512 |
| Business Phone Number: | 7043232248 |
| Business Fax Number: | 7049457671 |
| Mailing Address: | 4601 Park Rd, Suite 300 CHARLOTTE |
| State: | NC |
| Postal Code: | 282093239 |
| Phone Number: | 7043232248 |
| Fax Number: | 7049457671 |
| NPI Enumeration Date: | 06/20/2006 |
| NPI Last Update Date: | 08/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | PT2782 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |