Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACKSON D DAVENPORT, DPT
Active Sole ProprietorJACKSON D DAVENPORT, DPT is a Physical Therapy Assistant healthcare provider located in MUNSTER, Indiana. NPI 1376277905 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · MUNSTER, IN
Registration Details
- NPI Number
- 1376277905
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 11, 2022 (4.0747598442373 yrs)
- Last Updated
- Sep 26, 2022
- Licenses
-
05014727A (IN)070026760 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
9950 CALUMET AVEMUNSTER, IN, 463214028Browse IN providers · Browse ZIP 46321
- Phone
- 2199342840
- Fax
- 2199342841
- Primary Specialty
-
Physical Therapy Assistant
225100000X
- Additional Specialty
- Physical Therapy Assistant
Other Physical Therapy Assistant Providers in MUNSTER, IN
| Name | Credential | NPI |
|---|---|---|
| JUDITH D NUEROS | PT | 1033188867 |
| RICHARD DUTTWEILER | PHYSICAL THERAPIST | 1124068374 |
| DIANE DININO | PT | 1215970983 |
| ANNE L MCDONALD | PT | 1720012115 |
| DANIELLE LAREAU | PTA | 1326073032 |
| MICHAEL TOPOR | PT | 1982622239 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.