Provider Demographics
NPI:1750792693
Name:TARR, JAMES LANCE (PT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LANCE
Last Name:TARR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CRESTFIELD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-9323
Mailing Address - Country:US
Mailing Address - Phone:304-238-3145
Mailing Address - Fax:304-218-2299
Practice Address - Street 1:100 MARSHALL ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BENWOOD
Practice Address - State:WV
Practice Address - Zip Code:26031-1041
Practice Address - Country:US
Practice Address - Phone:304-218-2300
Practice Address - Fax:304-218-2299
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV2302225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist