Healthcare Provider Details

I. General information

NPI: 1013361088
Provider Name (Legal Business Name): JENNIFER COLE CHAPMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MCCRACKEN COLE PT

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 PHILLIPS BRANCH RD
PHELPS KY
41553-9061
US

IV. Provider business mailing address

518 SUNSHINE LN
KIMPER KY
41539-6449
US

V. Phone/Fax

Practice location:
  • Phone: 606-456-8725
  • Fax:
Mailing address:
  • Phone: 606-631-3174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004971
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: