Provider Demographics
NPI:1871900605
Name:BURGETT, JENNIFER SAVAGE (PHD, LAT, ATC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SAVAGE
Last Name:BURGETT
Suffix:
Gender:F
Credentials:PHD, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6197 VISTA TRL
Mailing Address - Street 2:
Mailing Address - City:SOUTHSIDE
Mailing Address - State:AL
Mailing Address - Zip Code:35907-5644
Mailing Address - Country:US
Mailing Address - Phone:770-519-0129
Mailing Address - Fax:
Practice Address - Street 1:1701 PELHAM RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-3353
Practice Address - Country:US
Practice Address - Phone:256-782-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2399174H00000X, 2255A2300X
TN2516174H00000X
GAAT0022602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No174H00000XOther Service ProvidersHealth Educator