Individual
JENSEN HACKETT WAGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
106 PEARL DR, SUITE 104, LA FAYETTE, GA 30728-7509
(706) 638-3880
(706) 638-3890
Mailing address
106 PEARL DR, SUITE 104, LA FAYETTE, GA 30728-7509
(706) 638-3880
(706) 638-3890
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012340
GA
Other
Enumeration date
05/26/2016
Last updated
08/16/2016
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