Provider Demographics
NPI:1952548448
Name:PERKINS, JEAN G (LMT)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:G
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 RIVER BIRCH CT
Mailing Address - Street 2:APT. 623
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5166
Mailing Address - Country:US
Mailing Address - Phone:407-375-2643
Mailing Address - Fax:
Practice Address - Street 1:600 RIVER BIRCH CT
Practice Address - Street 2:APT 623
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:407-375-2643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA38970225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist