Provider Demographics
NPI:1790932135
Name:ARMSTRONG, JASON LOUIS (PTA)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:LOUIS
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 PARADISE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-1626
Mailing Address - Country:US
Mailing Address - Phone:270-820-5995
Mailing Address - Fax:
Practice Address - Street 1:218 PARADISE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-1626
Practice Address - Country:US
Practice Address - Phone:270-820-5995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-A02255225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant