Provider Demographics
NPI:1508274325
Name:VERBIAR, JEANETTE MARIE (BS, LAT, ATC, EMT)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:MARIE
Last Name:VERBIAR
Suffix:
Gender:F
Credentials:BS, LAT, ATC, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 HEATHER RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2303
Mailing Address - Country:US
Mailing Address - Phone:484-653-9477
Mailing Address - Fax:
Practice Address - Street 1:241 HEATHER RIDGE CIR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-2303
Practice Address - Country:US
Practice Address - Phone:484-653-9477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0058842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer