Provider Demographics
NPI:1154403178
Name:GIRARD, JESSICA SUZZANNE (DPT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:SUZZANNE
Last Name:GIRARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13120 TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9508
Mailing Address - Country:US
Mailing Address - Phone:740-359-3364
Mailing Address - Fax:
Practice Address - Street 1:4738 KAE AVE
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-6100
Practice Address - Country:US
Practice Address - Phone:614-417-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist