Healthcare Provider Details

I. General information

NPI: 1013825553
Provider Name (Legal Business Name): JENNY JETT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6298 VETERANS PKWY STE 5B
COLUMBUS GA
31909-6244
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 706-225-0380
  • Fax: 706-225-0390
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP061196T
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: