Provider Demographics
NPI:1154104677
Name:AKINS, JAKE (DPT)
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:
Last Name:AKINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 ROUTE 37 E
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6729
Mailing Address - Country:US
Mailing Address - Phone:732-908-2610
Mailing Address - Fax:732-908-2612
Practice Address - Street 1:104 ROUTE 37 E
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6729
Practice Address - Country:US
Practice Address - Phone:732-908-2610
Practice Address - Fax:732-908-2612
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02198900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist