Provider Demographics
NPI:1578817870
Name:HARDIN, JAMES FREDRICK II
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FREDRICK
Last Name:HARDIN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7123 WOODS CROSSNG DR.
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-9058
Mailing Address - Country:US
Mailing Address - Phone:804-317-8372
Mailing Address - Fax:
Practice Address - Street 1:7123 WOODS CROSSING DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-9058
Practice Address - Country:US
Practice Address - Phone:804-317-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603437225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant