Provider Demographics
NPI:1710473921
Name:R. JASON KENT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:R. JASON KENT PHYSICAL THERAPY
Other - Org Name:R. JASON KENT PHYSICAL THERAPY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JANSON
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:478-333-3075
Mailing Address - Street 1:150 OSIGIAN BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088
Mailing Address - Country:US
Mailing Address - Phone:478-333-3075
Mailing Address - Fax:488-333-3484
Practice Address - Street 1:6040 LAKESIDE COMMONS DR.
Practice Address - Street 2:SUITE A
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210
Practice Address - Country:US
Practice Address - Phone:478-254-6880
Practice Address - Fax:478-333-3484
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R. JASON KENT PHYSICAL THERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-11
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty