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NPI Code Detail

MEDICARE: MS. JENNIFER EDGAR

MEDICARE: MS. JENNIFER EDGAR
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 AssistantPTA03203OH

General Provider Information

NPI Number : 1730248386
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER EDGAR
Provider Business Mailing Address
First Line : 61816 HAWTHORNE HILL RD
Second Line :
City : SHADYSIDE
State : OH
Zip : 43947-9708
Country : US
Telephone Number : 740-671-1901
Fax Number :
Provider Business Practice Location Address
First Line : 4697 HARRISON ST
Second Line :
City : BELLAIRE
State : OH
Zip : 43906-1338
Country : US
Telephone Number : 740-671-1421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 07/08/2007

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Directions to “ MS. JENNIFER EDGAR ” Practice Location

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