Jennifer Jack, PTA
Individual provider Active NPI Physical Therapy Assistant · Andrews, NC
NPI 1447680913 · NPPES record last updated Nov 20, 2013
Key facts
- NPI
- 1447680913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5214 (NC)
- Practice address
- 551 Kent St
Andrews, NC 28901-8088 - Phone
- (828) 321-3075
- NPI assigned
- Nov 20, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5214 | NC | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5214 | NC | Yes |
Addresses
Primary practice location
551 Kent St
Andrews, NC 28901-8088
Mailing address
PO Box 1367
Franklin, NC 28744-1367
Other providers in Andrews, NC
- Paula Hall
- Melanie Susan Hamby
- Sara Ighani
- Industrial Opportunities Inc.
- Holly Michelle Inglima
- James M. Vollmer DDS PA
- Jeffrey L Taylor, O.D.and Lynn C Taylor O.D., PA
- Dionne Julia Joseph
- Kerr Drug Inc
- Paul Judson Kinsland IV
All providers in Andrews, NC · Physical Therapy Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.