Funke, Jennifer G

Funke, Jennifer G is an individual health care provider with primary practice located at 3381 Kanell Blvd , Poplar Bluff MO 63901-3060. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Funke, Jennifer G can be contacted via phone (573) 775-0761.

Contact Information

Primary practice address
3381 Kanell Blvd Poplar Bluff MO 63901-3060
Phone: (573) 775-0761
Fax: (573) 785-0031
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2003022299 Missouri

Profile Details

NPI number 1912963398
LBN Legal business name Funke, Jennifer G
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Aug 20th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912963398 NPPES
Missouri MEDICAID 486083702

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