Provider Demographics
NPI:1881965937
Name:PERRY, JAMILYN MARIE (DPT, PT)
Entity type:Individual
Prefix:DR
First Name:JAMILYN
Middle Name:MARIE
Last Name:PERRY
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:JAMILYN
Other - Middle Name:MARIE
Other - Last Name:TARASCHUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1907 TALL TREES DR
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-2260
Mailing Address - Country:US
Mailing Address - Phone:570-878-5365
Mailing Address - Fax:
Practice Address - Street 1:1907 TALL TREES DR
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-2260
Practice Address - Country:US
Practice Address - Phone:570-878-5365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist