Healthcare Provider Details

I. General information

NPI: 1528209442
Provider Name (Legal Business Name): JASON DUDLEY ARMSTRONG PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 J L WHITE DR STE 110
JASPER GA
30143-4897
US

IV. Provider business mailing address

620 J L WHITE DR STE 110
JASPER GA
30143-4897
US

V. Phone/Fax

Practice location:
  • Phone: 706-692-9080
  • Fax: 706-692-1199
Mailing address:
  • Phone: 706-692-9080
  • Fax: 706-692-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP051202T
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT1495
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH9093
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: