Provider Demographics
NPI:1053824730
Name:ESPINOSA, JINKY (PT DPT)
Entity Type:Individual
Prefix:
First Name:JINKY
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 GLOUCESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1111
Mailing Address - Country:US
Mailing Address - Phone:910-527-8335
Mailing Address - Fax:
Practice Address - Street 1:1210 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1817
Practice Address - Country:US
Practice Address - Phone:252-462-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist