Individual
JENNIFER SPELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
120 DISTRICT BLVD STE D102, JACKSON, MS 39211-6304
(769) 204-8222
(769) 235-2751
Mailing address
PO BOX 306393, NASHVILLE, TN 37230-6393
(615) 373-1350
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2025
MS
225100000X
Physical Therapist
PTH - 4368
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51527313
BCBS OF ALABAMA
AL
05
—
890013590
—
AL
Enumeration date
07/25/2006
Last updated
05/13/2022
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