Individual
JACK STEPHEN HARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1451 GAMBIER RD, MOUNT VERNON, OH 43050-9112
(740) 397-1706
Mailing address
1217 PARK RD, CRESTLINE, OH 44827-1019
(419) 689-0192
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA008206
OH
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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