Provider Demographics
NPI:1710058854
Name:ZVANUT, JENNIFER FREY (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:FREY
Last Name:ZVANUT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10422 CARVER FALLS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-1469
Mailing Address - Country:US
Mailing Address - Phone:704-391-7002
Mailing Address - Fax:704-829-9810
Practice Address - Street 1:303 PARK ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3367
Practice Address - Country:US
Practice Address - Phone:704-829-9800
Practice Address - Fax:704-829-9810
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC83682251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic