| Jake C Jensen, PT, DPT | |
|
4204 Coral Park Dr, Brunswick, GA 31520-3016 | |
| (912) 280-9205 | |
| (912) 280-0022 |
| Full Name | Jake C Jensen |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 4204 Coral Park Dr, Brunswick, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538728423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT014005 (Georgia) | Primary |
| Provider Name | Greenville Proaxis Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1669457859 PECOS PAC ID: 0244267771 Enrollment ID: O20050726000769 |
| Mailing Address | Practice Location Address |
|---|---|
| Jake C Jensen, PT, DPT 3100 Olympus Blvd Ste 500, Coppell, TX 75019-5473 Ph: (866) 221-5405 | Jake C Jensen, PT, DPT 4204 Coral Park Dr, Brunswick, GA 31520-3016 Ph: (912) 280-9205 |
Ashley M. Tindle, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1106 Fountain Park Cir, Brunswick, GA 31520 Phone: 912-262-2151 Fax: 912-262-2754 | |
Mr. Jesus M Abad, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2415 Parkwood Dr, Brunswick, GA 31520 Phone: 912-466-2660 | |
Mrs. Amy Hamm Faircloth, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2415 Parkwood Dr, Brunswick, GA 31520 Phone: 912-466-2660 | |
Audrey E Herbert, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3231 Glynn Ave, Brunswick, GA 31520 Phone: 912-265-9006 Fax: 912-554-3636 | |
Dr. Ryan A. Conwell, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 216 Harrison Ln, Brunswick, GA 31520 Phone: 912-342-8982 Fax: 912-275-7677 | |
Lacie L Brown, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4204 Coral Park Dr, Brunswick, GA 31520 Phone: 912-280-9205 Fax: 912-280-0022 | |
Bradley David Seuntjens, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4204 Coral Park Dr, Brunswick, GA 31520 Phone: 912-280-9205 Fax: 912-280-0022 |