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Individual

JENNIFER E HART

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
901 W MORTON AVE, SUITE 16A, JACKSONVILLE, IL 62650-3146
(217) 245-4640
(217) 245-4642
Mailing address
PO BOX 144, MANCHESTER, IL 62663-0144
(217) 587-9205

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LINCOLN LAND COMMUNI
SCHOOL
Enumeration date
03/27/2006
Last updated
07/08/2007
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