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General NPI Number Information
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NPI Number | 1154635993
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Entity Type | Individual
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Provider Name | JONNA PFOUNTZ OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 1513 N 2ND ST
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City | MEMPHIS
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State | TN
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Zip | 38107-1003
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Country | US
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Telephone | 901-272-2494
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Fax |
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Provider Business Mailing Address
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Address Line | 64 S ARCADIAN CIR APT. 102
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City | MEMPHIS
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State | TN
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Zip | 38103-6924
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4221
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License Number State | TN
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