Provider Demographics
NPI:1467878298
Name:JEFFERS, JOSEPH NICHOLAS (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:NICHOLAS
Last Name:JEFFERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-8572
Mailing Address - Country:US
Mailing Address - Phone:336-334-4822
Mailing Address - Fax:336-819-2001
Practice Address - Street 1:601 HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-8572
Practice Address - Country:US
Practice Address - Phone:336-334-4822
Practice Address - Fax:336-819-2001
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP4993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist