Provider Demographics
NPI:1073669057
Name:HAMILTON, JENNIFER SCOTT (DPT, CHT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SCOTT
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DPT, CHT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:11007 MANKLIN CREEK RD
Mailing Address - Street 2:UNIT 5
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-4012
Mailing Address - Country:US
Mailing Address - Phone:410-822-4613
Mailing Address - Fax:
Practice Address - Street 1:119 W COLLEGE AVE STE 205
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6924
Practice Address - Country:US
Practice Address - Phone:410-742-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD435138000Medicaid
MD216538Medicare PIN