Individual provider · Type 1 NPI

Jenelle Deatherage, PT

Physical Therapist · Peoria, IL

NPI number 1720090830 Active

Practice location

9901 N Knoxville Ave, Ste D
Peoria, IL 61615-1429

Mailing address

850 43rd Ave Ste 100
Moline, IL 61265-8401

Specialties and licenses

TaxonomyCodeLicense
Physical Therapist 225100000X7357 (MN)
Physical Therapist Primary 225100000X070020706 (IL)

Physical Therapist: Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, r…

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About NPI 1720090830

Jenelle Deatherage, PT's National Provider Identifier is 1720090830, issued on Aug 13, 2006. The primary taxonomy on file is Physical Therapist (225100000X), and the practice location is in Peoria, IL. The record was last updated on Jun 26, 2014.