Provider Demographics
NPI:1033482575
Name:STUBBS, JESSICA T (PT)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:T
Last Name:STUBBS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:146 WALNUT LN STE A
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-1672
Mailing Address - Country:US
Mailing Address - Phone:864-834-0401
Mailing Address - Fax:864-834-9701
Practice Address - Street 1:146 WALNUT LN STE A
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-1672
Practice Address - Country:US
Practice Address - Phone:864-834-0401
Practice Address - Fax:864-834-9701
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPT.6633PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist