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General NPI Number Information
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NPI Number | 1770253049
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Entity Type | Organization
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Legal Business Name | JENMOBILITY REHAB
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 415 ISBILL RD STE E
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City | MADISONVILLE
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State | TN
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Zip | 37354-2148
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Country | US
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Telephone | 423-545-9544
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Fax | 423-545-9554
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Provider Business Mailing Address
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Address Line | PO BOX 863
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City | MADISONVILLE
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State | TN
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Zip | 37354-0863
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Country | US
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Telephone | 423-545-9544
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Fax | 423-545-9554
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER MORGAN
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Credential | OTR/L, CLT-LANA
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Telephone | 423-545-9544
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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 |
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License Number State |
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