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General NPI Number Information
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NPI Number | 1093067944
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Entity Type | Individual
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Provider Name | JENNIFER ANNE FINCH P.T.A.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 303 N HURSTBOURNE PKWY SUITE 200
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City | LOUISVILLE
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State | KY
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Zip | 40222-5185
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Country | US
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Telephone | 502-412-5847
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Fax |
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Provider Business Mailing Address
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Address Line | 11301 BROOKSHIRE DR
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City | GRAND BLANC
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State | MI
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Zip | 48439-1005
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Country | US
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Telephone | 810-694-7917
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5502002940
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License Number State | MI
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