Provider Demographics
NPI:1396471744
Name:HUNT, JENNIFER (PTA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 NEWNAN CROSSING BLVD E APT 4208
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-0010
Mailing Address - Country:US
Mailing Address - Phone:706-570-9222
Mailing Address - Fax:
Practice Address - Street 1:1755 HIGHWAY 34 E STE 1300
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-3186
Practice Address - Country:US
Practice Address - Phone:770-254-7850
Practice Address - Fax:770-254-1394
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003715225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant