Provider Demographics
NPI:1427452184
Name:WEST, JANIE (DPT)
Entity type:Individual
Prefix:MRS
First Name:JANIE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 OXFORD ST
Mailing Address - Street 2:PO BOX 288
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-2428
Mailing Address - Country:US
Mailing Address - Phone:731-587-3422
Mailing Address - Fax:731-587-3424
Practice Address - Street 1:104 OXFORD ST
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-2428
Practice Address - Country:US
Practice Address - Phone:731-587-3422
Practice Address - Fax:731-587-3424
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist