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NPI 1689639593

NPI 1689639593 : JAMES HARTLEY PT, ATC : MEDINA, OH

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General NPI Number Information
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    NPI Number           |    1689639593
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES HARTLEY PT, ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/20/2006
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    1000 E WASHINGTON ST 
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    City                 |    MEDINA
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    State                |    OH
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    Zip                  |    44256-2170
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    Country              |    US
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    Telephone            |    330-725-1000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4134 VANDEMARK RD 
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    City                 |    LITCHFIELD
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    State                |    OH
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    Zip                  |    44253-9793
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    Country              |    US
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    Telephone            |    330-721-6602
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT-9108
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    AT-582
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    License Number State |    OH
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