Individual
JODI A. SICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1051 4TH AVE, GALLIPOLIS, OH 45631
(740) 446-5244
(740) 446-5448
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5244
(740) 446-5448
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
002095
WV
225100000X
Physical Therapist
Primary
005681
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204797
OH MEDICAID UNISON
—
01
—
000000217353
ANTHEM BCBS
—
05
—
0156655000
—
WV
01
—
2222517
MOLINA MEDICAID
OH
05
—
2222517
—
OH
01
—
310917085343
MOUNTAIN STATE BCBS
—
01
—
650019672
RR MEDICARE
—
Enumeration date
07/17/2006
Last updated
05/16/2012
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