Healthcare Provider Details

I. General information

NPI: 1154636439
Provider Name (Legal Business Name): JENNIFER ANNE DUFRENE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 NOAH DRIVE SUITE 102
JASPER GA
30143-8707
US

IV. Provider business mailing address

371 NOAH DRIVE SUITE 102
JASPER GA
30143-8707
US

V. Phone/Fax

Practice location:
  • Phone: 706-253-6287
  • Fax: 888-557-0938
Mailing address:
  • Phone: 706-253-6287
  • Fax: 888-557-0938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT009965
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: