Individual
JANN ALLYN JENNELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, LMT
Contact information
Practice address
102 RUSSELL RD, ROSWELL, GA 30075-1147
(678) 431-7096
(678) 348-7334
Mailing address
125 W LAKE DR, ROSWELL, GA 30075-1140
(678) 431-7096
(678) 348-7334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008547
GA
225700000X
Massage Therapist
MT003325
GA
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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