Provider Demographics
NPI:1760872592
Name:PERRY, JAMIE (ATC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 BURNAGE WAY
Mailing Address - Street 2:APT 304
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7847
Mailing Address - Country:US
Mailing Address - Phone:315-396-1155
Mailing Address - Fax:
Practice Address - Street 1:411 BURNAGE WAY
Practice Address - Street 2:APT 304
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7847
Practice Address - Country:US
Practice Address - Phone:315-396-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer