Doctor Name: | JENSEN HACKETT WAGES |
NPI Number: | 1538517966 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT012340 |
Business Practice Address: | 106 Pearl Dr Suite 104 La Fayette, GA - 307287509 |
Business Phone Number: | 7066383880 |
Business Fax Number: | 7066383890 |
Mailing Address: | 106 Pearl Dr, Suite 104 LA FAYETTE |
State: | GA |
Postal Code: | 307287509 |
Phone Number: | 7066383880 |
Fax Number: | 7066383890 |
NPI Enumeration Date: | 05/26/2016 |
NPI Last Update Date: | 06/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT012340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |