Provider Demographics
NPI:1053554279
Name:SKURDA, JENNIFER JUDITH (PTA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JUDITH
Last Name:SKURDA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:729 W ANN ARBOR TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-6225
Mailing Address - Country:US
Mailing Address - Phone:734-414-7056
Mailing Address - Fax:734-414-9925
Practice Address - Street 1:729 W ANN ARBOR TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6225
Practice Address - Country:US
Practice Address - Phone:734-414-7056
Practice Address - Fax:734-414-9925
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant