Individual provider · Type 1 NPI
Jeremy Shane Tackett, PTA
Physical Therapy Assistant · Checotah, OK
Practice location
1013 W Park Ave
Checotah, OK 74426-1250
Fax (918) 473-1748
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | 1335 (OK) |
Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …
About NPI 1043412364
Jeremy Shane Tackett, PTA's National Provider Identifier is 1043412364, issued on May 31, 2007. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Checotah, OK. The record was last updated on Jul 8, 2007.