Healthcare Provider Details

I. General information

NPI: 1710803366
Provider Name (Legal Business Name): JARED STURGELL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 S WILKINSON WAY
PERRYSBURG OH
43551-2590
US

IV. Provider business mailing address

9462 COUNTY RD N
NAPOLEON OH
43545-6855
US

V. Phone/Fax

Practice location:
  • Phone: 419-591-9115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA014290
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: