| Doctor Name: | JENNIE ELLIS HAITHCOCK |
| NPI Number: | 1891013389 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 5762 |
| Business Practice Address: | 205 Midland Pkwy Summerville, SC - 294858122 |
| Business Phone Number: | 8438757163 |
| Business Fax Number: | 8438757169 |
| Mailing Address: | 2222 Sullivan Trl, EASTON |
| State: | PA |
| Postal Code: | 180407958 |
| Phone Number: | 8009449782 |
| Fax Number: | 6104382024 |
| NPI Enumeration Date: | 05/10/2010 |
| NPI Last Update Date: | 05/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5762 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| 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 |