Vistnes, Jennifer Robin

Vistnes, Jennifer Robin is an sole proprietor health care provider with primary practice located at 318 W Pike St Suite 104, Lawrenceville GA 30045-3234. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Vistnes, Jennifer Robin can be contacted via phone (678) 377-2833.

Contact Information

Primary practice address
318 W Pike St Suite 104 Lawrenceville GA 30045-3234
Phone: (678) 377-2833
Fax: (678) 377-2882
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 002800 Georgia

Profile Details

NPI number 1730242926
LBN Legal business name Vistnes, Jennifer Robin
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 18th, 2006
Last updated Jul 9th, 2007 - about 18 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 1730242926 NPPES
Georgia MEDICAID 00840804B
Georgia Other 10037643
Georgia Other 307939

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