Provider Demographics
NPI:1831477561
Name:PRACHAR, JAMIE ELIZABETH (PTA)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:PRACHAR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8010 GERMANTOWN AVE
Mailing Address - Street 2:APT A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3441
Mailing Address - Country:US
Mailing Address - Phone:610-914-4179
Mailing Address - Fax:
Practice Address - Street 1:8010 GERMANTOWN AVE
Practice Address - Street 2:APT A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3441
Practice Address - Country:US
Practice Address - Phone:610-914-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE009068225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant