Provider Demographics
NPI:1205017456
Name:RINEFIERD, JENNIFER KAYE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KAYE
Last Name:RINEFIERD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 HEADS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-4578
Mailing Address - Country:US
Mailing Address - Phone:706-778-7087
Mailing Address - Fax:
Practice Address - Street 1:1210 HEADS FERRY RD
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531-4578
Practice Address - Country:US
Practice Address - Phone:706-778-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1969225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant