Individual
JASON PADGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
105 MAIN ST # 891, PANAMA, IL 62077-4448
(217) 556-6879
Mailing address
105 MAIN ST # 891, PANAMA, IL 62077-4448
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004980
IL
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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