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General NPI Number Information
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NPI Number | 1336663269
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Entity Type | Individual
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Provider Name | JESSICA NICOLE TRANI PTA
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Gender | Female
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 09/12/2017
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Provider Practice Location Address
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Address Line | 3039 OKATIE HWY
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City | OKATIE
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State | SC
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Zip | 29909-5101
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Country | US
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Telephone | 843-705-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 14 TRAVERTINE CIR
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City | SAVANNAH
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State | GA
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Zip | 31419-9498
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Country | US
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Telephone | 636-614-5236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 3812
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License Number State | SC
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