Provider Demographics
NPI:1215659651
Name:PRESLEY, JENIFER B (DPT)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:B
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:
Other - Last Name:BURLESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3290 RIDGEWAY DR STE 3
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2023
Mailing Address - Country:US
Mailing Address - Phone:319-665-2630
Mailing Address - Fax:319-665-2631
Practice Address - Street 1:3620 EDGEWOOD RD SW STE 300
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-7205
Practice Address - Country:US
Practice Address - Phone:319-363-2901
Practice Address - Fax:319-363-2903
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist