Provider Demographics
NPI:1891527248
Name:CHRISTENSEN, JENNA LAUREN (DPT)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:LAUREN
Last Name:CHRISTENSEN
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 1:325 N FRONT ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1410
Mailing Address - Country:US
Mailing Address - Phone:585-857-3033
Mailing Address - Fax:
Practice Address - Street 1:420 BAINBRIDGE ST STE 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1568
Practice Address - Country:US
Practice Address - Phone:215-413-0633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist