Provider Demographics
NPI:1982880993
Name:QUINT, JENNIFER JANE (DPT, MS, ATC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JANE
Last Name:QUINT
Suffix:
Gender:F
Credentials:DPT, MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 WESTPORT RD
Mailing Address - Street 2:STE A
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3832
Mailing Address - Country:US
Mailing Address - Phone:270-352-1061
Mailing Address - Fax:270-352-1067
Practice Address - Street 1:2102A TRENTON RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-1609
Practice Address - Country:US
Practice Address - Phone:931-552-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008150225100000X
TN8022225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3727276Medicaid
3727276Medicare PIN