Provider Demographics
NPI:1073196606
Name:JENERGY FOR LIFE, LLC
Entity Type:Organization
Organization Name:JENERGY FOR LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DICKENS
Authorized Official - Last Name:MASSIE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:423-258-4678
Mailing Address - Street 1:2301 RED MILE RD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-6689
Mailing Address - Country:US
Mailing Address - Phone:423-258-4678
Mailing Address - Fax:
Practice Address - Street 1:2301 RED MILE RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-6689
Practice Address - Country:US
Practice Address - Phone:423-258-4678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy