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General NPI Number Information
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NPI Number | 1518195528
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Entity Type | Individual
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Provider Name | JER'RELL GARTH HUNT JR. L.M.T. / M.M.P.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 32823 FM 2978 RD
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City | MAGNOLIA
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State | TX
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Zip | 77354-6060
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Country | US
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Telephone | 832-934-2344
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Fax |
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Provider Business Mailing Address
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Address Line | 18819 BERRY HILL DR
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City | TOMBALL
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State | TX
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Zip | 77377-7520
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Country | US
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Telephone | 281-351-7238
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT038290
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License Number State | TX
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