Provider Demographics
NPI:1790096097
Name:GRUSSEMEYER, JESSICA NEFF (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:NEFF
Last Name:GRUSSEMEYER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:NEFF
Other - Last Name:GRUSSEMEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:670 NORTH AVE NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1100
Mailing Address - Country:US
Mailing Address - Phone:770-792-8081
Mailing Address - Fax:770-792-8083
Practice Address - Street 1:670 NORTH AVE NW
Practice Address - Street 2:SUITE 201
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1100
Practice Address - Country:US
Practice Address - Phone:770-792-8081
Practice Address - Fax:770-792-8083
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0099422251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic