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NPI Code Detail

MEDICARE: JARROD HENRY

MEDICARE: JARROD HENRY
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 AssistantPTA. 09651OH

General Provider Information

NPI Number : 1699167114
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARROD HENRY
Provider Business Mailing Address
First Line : 2701 CHESTNUT STATION CT
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-6395
Country : US
Telephone Number : 800-335-1060
Fax Number :
Provider Business Practice Location Address
First Line : 11230 PIPPIN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45231-1202
Country : US
Telephone Number : 513-851-0601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2015
Last Update Date : 02/20/2015

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