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Individual

JENNA MICHELLE KIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
420 DEAN DR, GARDENDALE, AL 35071-2763
(205) 631-8709
Mailing address
9517 PHARRIS LN, KIMBERLY, AL 35091-3005
(205) 789-9935

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5696
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225200000X
AL
Enumeration date
09/29/2017
Last updated
09/29/2017
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