Corey Allen Jasper, PTA

Individual provider Active NPI Physical Therapy Assistant · Rushville, OH

NPI 1508412487 · NPPES record last updated Aug 15, 2019

Key facts

NPI
1508412487
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA.011112 (OH)
Practice address
4534 County Road 62
Rushville, OH 43150
Phone
(740) 583-4935
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA.011112OHMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA.011112 OH Yes

Addresses

Primary practice location

4534 County Road 62
Rushville, OH 43150

Mailing address

339 E Maple St
North Canton, OH 44720-2593
Phone (330) 498-8200

Other providers in Rushville, OH

All providers in Rushville, OH · Physical Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.