Provider Demographics
NPI:1326439381
Name:PEARCE, JAMES C JR (PTA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:PEARCE
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3537 N CROSSING CIR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1019
Mailing Address - Country:US
Mailing Address - Phone:229-333-0095
Mailing Address - Fax:229-333-0756
Practice Address - Street 1:3537 N CROSSING CIR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1019
Practice Address - Country:US
Practice Address - Phone:229-333-0095
Practice Address - Fax:229-333-0756
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA001569225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant