Individual
MR. JEFFERY A AGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1223 JULIAN R ALLSBROOK HWY, ROANOKE RAPIDS, NC 27870-5126
(252) 537-1215
(252) 537-1816
Mailing address
PO BOX 7594, ROCKY MOUNT, NC 27804-0594
(252) 443-9103
(252) 451-9032
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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