Tridico, Jamie L.

Tridico, Jamie L. is an individual health care provider with primary practice located at 4301 Maccorkle Ave Se , Charleston WV 25304-2503. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Tridico, Jamie L. can be contacted via phone (304) 720-9185.

Contact Information

Primary practice address
4301 Maccorkle Ave Se Charleston WV 25304-2503
Phone: (304) 720-9185
Fax: (304) 720-9186
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1220 West Virginia

Profile Details

NPI number 1780882928
LBN Legal business name Tridico, Jamie L.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2007
Last updated Feb 20th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780882928 NPPES
West Virginia MEDICAID 3810009418

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