Healthcare Provider Details

I. General information

NPI: 1538407341
Provider Name (Legal Business Name): JENNIFER MOTT ABSHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 05/24/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S CAMPBELL ST
BURGAW NC
28425-5011
US

IV. Provider business mailing address

4001 BRADDOCK RD
HIGH POINT NC
27265-9155
US

V. Phone/Fax

Practice location:
  • Phone: 910-259-6007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4728
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: