Provider Demographics
NPI:1891117271
Name:PINKLEY, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:PINKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7893 SHILLING RD
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44287-9314
Mailing Address - Country:US
Mailing Address - Phone:330-464-6050
Mailing Address - Fax:
Practice Address - Street 1:3477 COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7126
Practice Address - Country:US
Practice Address - Phone:330-464-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016552225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist