Provider Demographics
NPI:1891008355
Name:JAMES, JODI CHARITY (DPT)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:CHARITY
Last Name:JAMES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:CHARITY
Other - Last Name:MULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:130 MARVIN RD SE
Practice Address - Street 2:SUITE 203
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-6100
Practice Address - Country:US
Practice Address - Phone:360-456-3300
Practice Address - Fax:360-456-6060
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60160943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist