Provider Demographics
NPI:1851493274
Name:HOWELL, JEFFREY RYAN (MPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:RYAN
Last Name:HOWELL
Suffix:
Gender:M
Credentials:MPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4337
Mailing Address - Country:US
Mailing Address - Phone:530-529-3636
Mailing Address - Fax:530-529-2241
Practice Address - Street 1:710 SOLANO ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:CA
Practice Address - Zip Code:96021-3352
Practice Address - Country:US
Practice Address - Phone:530-529-3636
Practice Address - Fax:530-529-2241
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT212370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGPT000630Medicare ID - Type UnspecifiedMEDICARE GROUP ID
CA0PT212370Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID