Provider Demographics
NPI:1346859311
Name:KENT, JAIME E (LAT)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:E
Last Name:KENT
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 S YADKIN AVE
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:NC
Mailing Address - Zip Code:28159-2349
Mailing Address - Country:US
Mailing Address - Phone:828-243-4015
Mailing Address - Fax:
Practice Address - Street 1:701 W MONROE ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5213
Practice Address - Country:US
Practice Address - Phone:701-216-6011
Practice Address - Fax:704-216-6278
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-15172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer