Provider Demographics
NPI:1063774479
Name:PILCHER, SHARON JARNAGIN (PTA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:JARNAGIN
Last Name:PILCHER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12271 64.50 RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-8833
Mailing Address - Country:US
Mailing Address - Phone:970-240-4867
Mailing Address - Fax:
Practice Address - Street 1:1401 S CASCADE AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5003
Practice Address - Country:US
Practice Address - Phone:970-249-9634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA-12754225200000X
225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant