| Doctor Name: | JODIE HUMPHREY |
| NPI Number: | 1730334392 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, ATC, CSCS |
| License Number: | 10872 |
| Business Practice Address: | 111 Brewster St Pawtucket, RI - 028604474 |
| Business Phone Number: | 4017292316 |
| Business Fax Number: | |
| Mailing Address: | Po Box 61, SEEKONK |
| State: | MA |
| Postal Code: | 02771 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/24/2008 |
| NPI Last Update Date: | 05/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 10872 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| 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 |