Provider Demographics
NPI:1982873774
Name:TEPSIC, JODI GOLDEN (MPT)
Entity type:Individual
Prefix:MS
First Name:JODI
Middle Name:GOLDEN
Last Name:TEPSIC
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:JODI
Other - Middle Name:ANN
Other - Last Name:GOLDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:2038 SMITH TOWNSHIP STATE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-9701
Mailing Address - Country:US
Mailing Address - Phone:724-947-1002
Mailing Address - Fax:724-947-1007
Practice Address - Street 1:2038 SMITH TOWNSHIP STATE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BURGETTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15021-9701
Practice Address - Country:US
Practice Address - Phone:724-947-1002
Practice Address - Fax:724-947-1007
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA015245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA076754QLWMedicare PIN