Individual
MRS. JESSICA BLYSTONE YAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
101 MEDICAL DRIVE, ELIZABETH CITY, NC 27909
(252) 338-2114
(252) 338-2115
Mailing address
101 MEDICAL DRIVE, ELIZABETH CITY, NC 27909
(252) 338-2114
(252) 338-2115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9994
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079XW
BCBS
NC
05
—
7211953
—
NC
Enumeration date
01/02/2007
Last updated
08/31/2011
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