| Doctor Name: | JENNIFER G FUNKE |
| NPI Number: | 1912963398 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 2003022299 |
| Business Practice Address: | 3381 Kanell Blvd Poplar Bluff, MO - 639013060 |
| Business Phone Number: | 5737750761 |
| Business Fax Number: | 5737850031 |
| Mailing Address: | Po Box 1064, POPLAR BLUFF |
| State: | MO |
| Postal Code: | 639021064 |
| Phone Number: | 5737789348 |
| Fax Number: | 5736860178 |
| NPI Enumeration Date: | 04/25/2006 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2003022299 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| 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 |