Provider Demographics
NPI:1093183899
Name:RAMIREZ, JESSICA NOELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:NOELLE
Last Name:RAMIREZ
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 1:867 GREENWOOD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3722
Mailing Address - Country:US
Mailing Address - Phone:404-600-4627
Mailing Address - Fax:470-270-8130
Practice Address - Street 1:867 GREENWOOD AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3722
Practice Address - Country:US
Practice Address - Phone:404-600-4627
Practice Address - Fax:470-270-8130
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30610225100000X
GA012201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist