Waters, Jeffrie Glenn

Waters, Jeffrie Glenn is an sole proprietor health care provider with primary practice located at 1685 Shaffer Rd , Atwater CA 95301-4456. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Waters, Jeffrie Glenn can be contacted via phone (209) 357-3420.

Contact Information

Primary practice address
1685 Shaffer Rd Atwater CA 95301-4456
Phone: (209) 357-3420
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 9195 California

Profile Details

NPI number 1821426859
LBN Legal business name Waters, Jeffrie Glenn
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 30th, 2013
Last updated Oct 30th, 2013 - about 12 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 1821426859 NPPES
California Other 9195 PHYSICAL THERAPIST ASSISTANT LICENSE NUMBER

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