Individual
MR. JEFFERY A AGAN
Active
Individual
MR. JEFFERY A AGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8770
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078PA
BCBS
NC
01
—
195519
MEDCOST
NC
01
—
650023761
RAILROAD MEDICARE
NC
05
—
7211214
—
NC
01
—
7714417
AETNA
NC
Enumeration date
09/26/2006
Last updated
08/03/2011
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