Tatlock, Jennifer Marie

Tatlock, Jennifer Marie is an individual health care provider with primary practice located at 178 Clizbe Ave , Amsterdam NY 12010-2935. 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. Tatlock, Jennifer Marie can be contacted via phone (518) 842-1425.

Contact Information

Primary practice address
178 Clizbe Ave Amsterdam NY 12010-2935
Phone: (518) 842-1425
Fax: (518) 842-1706
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 032826-1 New York

Profile Details

NPI number 1871807958
LBN Legal business name Tatlock, Jennifer Marie
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2010
Last updated Aug 12th, 2013 - about 11 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 1871807958 NPPES
New York MEDICAID 03005754

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