Provider Demographics
NPI:1942406194
Name:JARVIES, PAULA FAYE (PTA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:FAYE
Last Name:JARVIES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8536 GOVERNORS LN
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9102
Mailing Address - Country:US
Mailing Address - Phone:910-429-1182
Mailing Address - Fax:
Practice Address - Street 1:1601 PURDUE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3674
Practice Address - Country:US
Practice Address - Phone:910-486-5000
Practice Address - Fax:910-672-0061
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3174225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant