Healthcare Provider Details

I. General information

NPI: 1881767945
Provider Name (Legal Business Name): JTJ MARKETING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 BRIDGE ST 500
FORT WORTH TX
76112-2384
US

IV. Provider business mailing address

5601 BRIDGE ST 500
FORT WORTH TX
76112-2384
US

V. Phone/Fax

Practice location:
  • Phone: 817-457-9850
  • Fax: 817-457-9865
Mailing address:
  • Phone: 817-457-9850
  • Fax: 817-457-9865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. JARROD M ROGERS
Title or Position: OWNER
Credential:
Phone: 214-577-9191