Provider Demographics
NPI:1871745968
Name:SCHRAGEN, JENNY REBECAH (MSPT)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:REBECAH
Last Name:SCHRAGEN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-5429
Mailing Address - Country:US
Mailing Address - Phone:603-733-7339
Mailing Address - Fax:
Practice Address - Street 1:325 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:BOSCAWEN
Practice Address - State:NH
Practice Address - Zip Code:03303-2410
Practice Address - Country:US
Practice Address - Phone:603-796-2165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist