Provider Demographics
NPI:1184438509
Name:JEFFRIES, ERIC THOMAS (DPT, PT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:THOMAS
Last Name:JEFFRIES
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:NANTICOKE
Mailing Address - State:PA
Mailing Address - Zip Code:18634-1022
Mailing Address - Country:US
Mailing Address - Phone:570-592-0593
Mailing Address - Fax:
Practice Address - Street 1:220 E CENTER HILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-1147
Practice Address - Country:US
Practice Address - Phone:570-674-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT033029225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist