Provider Demographics
NPI:1770876757
Name:LOVETT, JERRIS L (DPT)
Entity type:Individual
Prefix:
First Name:JERRIS
Middle Name:L
Last Name:LOVETT
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 1:1911 ERIC DR
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30741-5426
Mailing Address - Country:US
Mailing Address - Phone:236-458-2814
Mailing Address - Fax:
Practice Address - Street 1:122 BATTLEFIELD CROSSING CT
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-5176
Practice Address - Country:US
Practice Address - Phone:706-861-5940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT01266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist