Provider Demographics
NPI:1962426858
Name:THORP, JACOB (PT, DHS)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:THORP
Suffix:
Gender:M
Credentials:PT, DHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MOYE BLVD
Mailing Address - Street 2:EAST CAROLINA UNIVERSITY; PT DEPARTMENT
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:252-744-6237
Mailing Address - Fax:252-744-6240
Practice Address - Street 1:2325 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7534
Practice Address - Country:US
Practice Address - Phone:252-695-6322
Practice Address - Fax:252-695-6321
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC115182251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports