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General NPI Number Information
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NPI Number | 1477751048
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Entity Type | Individual
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Provider Name | JEANNE RENE BRUNETTE PT
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 130 MEADOWLARK DR
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City | RICHMOND
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State | KY
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Zip | 40475-2238
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Country | US
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Telephone | 859-623-9472
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Fax |
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Provider Business Mailing Address
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Address Line | 4557 WALNUT CREEK DR.
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City | LEXINGTON
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State | KY
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Zip | 40509-4540
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Country | US
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Telephone | 859-576-8343
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 003463
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License Number State | KY
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