DPT/MS Jack Anthony Spatafore, NPI 1093711657
Specialist in Bridgeport, WV, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1093711657
NPI Entity Type Individual
Provider Name DPT/MS Jack Anthony Spatafore
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 306 W Main St, Bridgeport, WV, US
Provider Mailing Address 306 W Main St, Bridgeport, WV, US, 263301751
Is Sole Proprietor? No
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Primary Taxonomy

Taxonomy Code

174400000X

Taxonomy Name Specialist
Classification

Specialist

Group

Other Service Providers

License No. 002038
License State WV
Description An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

DPT/MS Jack Anthony Spatafore
306 W Main St

Bridgeport, WV, US

Phone: 304-842-3137
Fax: 304-842-3138

Mailing Address

DPT/MS Jack Anthony Spatafore
306 W Main St
Bridgeport, WV, US
ZIP 263301751
Phone: 304-842-3137
Fax: 304-842-3138

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

225100000X

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Physical Therapist

002038 WV No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
01071873100 WV WV WORKERS' COMPENSATION 01
1382862 WV UMWA 01
7305012-001 WV MEDICAID 05
WV51916B WV HEALTH PLAN 01
701615 WV AETNA 01
650023875 WV RAILROAD MEDICARE 01
010718731004 WV BLUE CROSS 01
135810 WV HEALTH ASSURANCE 01
398789 WV OPTIMUM CHOICE 01

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Montana Wallace

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Mary Mccullough

Individual

Personal Care Attendant

1599 2nd Ave

Charleston, WV

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