Henry, Jacquelyn Marie

Henry, Jacquelyn Marie is an sole proprietor health care provider with primary practice located at 5361 Brownwood Drive , Powder Springs GA 30127-4719. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Henry, Jacquelyn Marie can be contacted via phone (404) 849-2710.

Contact Information

Primary practice address
5361 Brownwood Drive Powder Springs GA 30127-4719
Phone: (404) 849-2710
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT005494 Georgia

Profile Details

NPI number 1528386141
LBN Legal business name Henry, Jacquelyn Marie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 6th, 2010
Last updated May 6th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528386141 NPPES
Georgia MEDICAID 199540486A

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