Healthcare Provider Details

I. General information

NPI: 1982842688
Provider Name (Legal Business Name): JENNA LEIGH HURT P.T., D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S 6TH ST
LOUISVILLE KY
40203-2123
US

IV. Provider business mailing address

2519 WALLACE AVE #C2
LOUISVILLE KY
40205-2255
US

V. Phone/Fax

Practice location:
  • Phone: 502-568-1000
  • Fax:
Mailing address:
  • Phone: 502-544-3781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number005380
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: