Healthcare Provider Details

I. General information

NPI: 1992731764
Provider Name (Legal Business Name): R JASON KENT PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date: 09/06/2018
Reactivation Date: 09/13/2018

III. Provider practice location address

140 OSIGIAN BLVD STE 300
WARNER ROBINS GA
31088-8029
US

IV. Provider business mailing address

140 OSIGIAN BLVD STE 300
WARNER ROBINS GA
31088-8029
US

V. Phone/Fax

Practice location:
  • Phone: 478-333-3075
  • Fax: 478-333-3484
Mailing address:
  • Phone: 478-333-3075
  • Fax: 478-333-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT007275
License Number StateGA

VIII. Authorized Official

Name: DR. RICHARD JASON KENT
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT
Phone: 478-333-3075