Provider Demographics
NPI:1114275450
Name:FRANK, JEAN R (PTA)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:R
Last Name:FRANK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3646
Mailing Address - Country:US
Mailing Address - Phone:610-489-7703
Mailing Address - Fax:610-489-7793
Practice Address - Street 1:78 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3646
Practice Address - Country:US
Practice Address - Phone:610-489-7703
Practice Address - Fax:610-489-7793
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE009408225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant