Provider Demographics
NPI:1821296989
Name:HAMILTON, JENNIFER (DPT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 RAMSEY ST STE 108
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-7189
Mailing Address - Country:US
Mailing Address - Phone:910-484-3332
Mailing Address - Fax:910-483-7301
Practice Address - Street 1:6000 RAMSEY ST STE 108
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-7189
Practice Address - Country:US
Practice Address - Phone:910-484-3332
Practice Address - Fax:910-483-7301
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11187225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11187OtherNC STATE LICENCE