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General NPI Number Information
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NPI Number | 1427829597
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Entity Type | Organization
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Legal Business Name | JESSICA M FUTCH PT DPT LLC
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 812 TOWNE PARK DR STE 400
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City | RINCON
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State | GA
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Zip | 31326-9364
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Country | US
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Telephone | 912-678-5132
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 PATTERSON DR
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City | GUYTON
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State | GA
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Zip | 31312-5142
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Country | US
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Telephone | 912-433-1269
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JESSICA M FUTCH
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Credential | PT, DPT
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Telephone | 912-433-1269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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