Healthcare Provider Details

I. General information

NPI: 1013858489
Provider Name (Legal Business Name): JADE HARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

987 E ASH ST # 204
PIQUA OH
45356-4133
US

IV. Provider business mailing address

8338 PIQUA LOCKINGTON RD
PIQUA OH
45356-9701
US

V. Phone/Fax

Practice location:
  • Phone: 937-570-5035
  • Fax:
Mailing address:
  • Phone: 937-570-5035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number33.026282
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: