Provider Demographics
NPI:1295854636
Name:STRATTON, JEFFREY LEE (MPT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:LEE
Last Name:STRATTON
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 DAIRY LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4871
Mailing Address - Country:US
Mailing Address - Phone:304-345-1090
Mailing Address - Fax:
Practice Address - Street 1:800 ASSOCIATION DR
Practice Address - Street 2:SUITE 209
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1272
Practice Address - Country:US
Practice Address - Phone:304-342-7049
Practice Address - Fax:304-342-7206
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2015-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2044225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist