Provider Demographics
NPI:1932270287
Name:KERTSCHER, JEFF THOMAS (PT)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:THOMAS
Last Name:KERTSCHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 LOW MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5838
Mailing Address - Country:US
Mailing Address - Phone:706-210-3999
Mailing Address - Fax:706-210-5017
Practice Address - Street 1:688 LOW MEADOW DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-5838
Practice Address - Country:US
Practice Address - Phone:706-210-3999
Practice Address - Fax:706-210-5017
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62962251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics