Provider Demographics
NPI:1336741529
Name:PARENT, JAMIE (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PARENT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 S DELSEA DR STE C
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5306
Mailing Address - Country:US
Mailing Address - Phone:856-690-1616
Mailing Address - Fax:856-896-6107
Practice Address - Street 1:298 S DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4568
Practice Address - Country:US
Practice Address - Phone:856-690-1616
Practice Address - Fax:856-690-1089
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01971400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist