Individual
MR. CHARLES JASON WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1008 BOLL WEEVIL CIR STE C, ENTERPRISE, AL 36330-3400
(334) 352-3331
(334) 268-5045
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2247
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH5351
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103110
—
AL
05
—
121677
—
AL
01
—
511-09123
BCBS OF ALABAMA
AL
01
—
515-92313
BCBS - EPRISE
AL
Enumeration date
05/12/2008
Last updated
08/08/2024
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