Provider Demographics
NPI:1255617486
Name:DOYLE, JENNIFER (DPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MOHNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:902 W ERIE PLZ
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4536
Mailing Address - Country:US
Mailing Address - Phone:814-456-6000
Mailing Address - Fax:814-456-6060
Practice Address - Street 1:4472 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510-2228
Practice Address - Country:US
Practice Address - Phone:814-464-0660
Practice Address - Fax:814-464-0663
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026046225100000X
MA19758225100000X
CT14651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT026046OtherPA LICENSE