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NPI Code Detail

MEDICARE: JACQUELINE HARPER PTA

MEDICARE: JACQUELINE HARPER PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant001624WV

General Provider Information

NPI Number : 1447793112
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE HARPER PTA
Provider Business Mailing Address
First Line : 115 SUMMERS HOSPITAL RD
Second Line :
City : HINTON
State : WV
Zip : 25951-5172
Country : US
Telephone Number : 304-466-2908
Fax Number : 304-466-2940
Provider Business Practice Location Address
First Line : 115 SUMMERS HOSPITAL RD
Second Line :
City : HINTON
State : WV
Zip : 25951-5172
Country : US
Telephone Number : 304-466-2908
Fax Number : 304-466-2940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2016
Last Update Date : 11/29/2016

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Directions to “ JACQUELINE HARPER PTA” Practice Location

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