Provider Demographics
NPI:1144527862
Name:FARQUHAR, JENNA UPTON (PT)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:UPTON
Last Name:FARQUHAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:CECILE
Other - Last Name:UPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2129 HELTON DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1069
Mailing Address - Country:US
Mailing Address - Phone:256-764-9304
Mailing Address - Fax:256-764-9343
Practice Address - Street 1:2129 HELTON DR
Practice Address - Street 2:STE C
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1069
Practice Address - Country:US
Practice Address - Phone:256-764-9304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist