Provider Demographics
NPI:1487251823
Name:MUNK, JESSICA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:MUNK
Suffix:
Gender:F
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 1:1314 WESTGATE PKWY STE 7
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2154
Mailing Address - Country:US
Mailing Address - Phone:334-268-5880
Mailing Address - Fax:334-268-5880
Practice Address - Street 1:1314 WESTGATE PKWY STE 7
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2154
Practice Address - Country:US
Practice Address - Phone:334-268-5880
Practice Address - Fax:334-268-5880
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9923225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist