Provider Demographics
NPI:1013566199
Name:J.L HUNT THERAPEUTICS
Entity Type:Organization
Organization Name:J.L HUNT THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:586-295-5505
Mailing Address - Street 1:43700 WOODWARD AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5060
Mailing Address - Country:US
Mailing Address - Phone:586-295-5505
Mailing Address - Fax:
Practice Address - Street 1:43700 WOODWARD AVE STE 108
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5060
Practice Address - Country:US
Practice Address - Phone:586-295-5505
Practice Address - Fax:586-279-1696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation