Provider Demographics
NPI:1144465550
Name:WEBSTER, JENNIFER M (R PT)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:M
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:R PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5459 BENTGRASS DR UNIT 111
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-2675
Mailing Address - Country:US
Mailing Address - Phone:941-284-4113
Mailing Address - Fax:
Practice Address - Street 1:5459 BENTGRASS DR UNIT 111
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-2675
Practice Address - Country:US
Practice Address - Phone:941-284-4113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-14
Last Update Date:2008-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104382251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics