Provider Demographics
NPI:1124305412
Name:HUTCHESON, JAMIE CAROL (PT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:CAROL
Last Name:HUTCHESON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:CAROL
Other - Last Name:MCARTHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:620 J L WHITE DR
Mailing Address - Street 2:STE 110
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-4896
Mailing Address - Country:US
Mailing Address - Phone:404-367-2088
Mailing Address - Fax:
Practice Address - Street 1:620 J L WHITE DR
Practice Address - Street 2:STE 110
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-4896
Practice Address - Country:US
Practice Address - Phone:404-367-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist