Individual
JAMIE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(540) 886-6233
Mailing address
213 GREENWOOD RD, STAUNTON, VA 24401-1883
(814) 571-1275
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603152
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2306603152
VIRGINIA BOARD
VA
Enumeration date
10/27/2015
Last updated
10/27/2015
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