Provider Demographics
NPI:1457527087
Name:MAJOR, JERMAINE LARON (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:JERMAINE
Middle Name:LARON
Last Name:MAJOR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 WISSAHICKON AVE
Mailing Address - Street 2:APT. M805C
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-5653
Mailing Address - Country:US
Mailing Address - Phone:215-843-0852
Mailing Address - Fax:
Practice Address - Street 1:5500 WISSAHICKON AVE
Practice Address - Street 2:APT. M805C
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-5653
Practice Address - Country:US
Practice Address - Phone:215-843-0852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-04
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017687225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist