Jessie Rae O'Leary, PT, DPT
Physical Therapist in South Bend, IN. Individual provider (NPI-1).
NPI number1376996157
StatusActive
Last updated in NPPESMar 31, 2021
Details
- NPI
- 1376996157
- Entity type
- Individual (NPI-1)
- Name
- Jessie Rae O'Leary
- Credential
- PT, DPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 18, 2016
- Certification date
- Mar 31, 2021
- Last updated
- Mar 31, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 05012860A | IN | Yes |
| 225100000X | Physical Therapist | PT32444 | FL |
Other names
- Jessie Rae McKanna (Former Name)
Practice location
1815 E Ireland Rd Ste 100South Bend, IN 46614-2845
Phone 574-647-5790 · Fax 574-647-5792
Mailing address
710 N Niles AveSouth Bend, IN 46617-1924
Phone 574-647-1610 · Fax 574-647-2376
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