Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT018843 | PA |
NPI | 1003096884 |
---|---|
Provider Name | Jason Everett Rarich |
First Address | Newtown Square, PA 19073-0259 |
Second Address | Collegeville, PA 19426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 24/06/2019 |