Provider Demographics
NPI:1366932626
Name:RISEN, JASMIN HIZAROGLU (PT, MPT, DPT)
Entity type:Individual
Prefix:DR
First Name:JASMIN
Middle Name:HIZAROGLU
Last Name:RISEN
Suffix:
Gender:F
Credentials:PT, MPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-4724
Mailing Address - Country:US
Mailing Address - Phone:336-264-0462
Mailing Address - Fax:
Practice Address - Street 1:2617 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-4724
Practice Address - Country:US
Practice Address - Phone:336-264-0462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-12
Last Update Date:2018-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP88342251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics