Provider Demographics
NPI:1770775280
Name:DUNLAP, JENNIFER (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:HURLBUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6711 MOUNTAIN VIEW RD STE 115
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6667
Mailing Address - Country:US
Mailing Address - Phone:423-238-1127
Mailing Address - Fax:
Practice Address - Street 1:5572 LITTLE DEBBIE PKWY
Practice Address - Street 2:STE. 122
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4364
Practice Address - Country:US
Practice Address - Phone:423-238-4141
Practice Address - Fax:423-238-4142
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003009573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist