Provider Demographics
NPI:1588225684
Name:JENKINS, AUSTIN JAMES (PT, DPT)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JAMES
Last Name:JENKINS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-5029
Mailing Address - Country:US
Mailing Address - Phone:865-908-7041
Mailing Address - Fax:865-908-7043
Practice Address - Street 1:1787 VETERANS BLVD STE 102C
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6946
Practice Address - Country:US
Practice Address - Phone:865-366-3043
Practice Address - Fax:865-366-3044
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist