Provider Demographics
NPI:1962705871
Name:YARBER, JASON P (DPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:P
Last Name:YARBER
Suffix:
Gender:M
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:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:BALDWYN
Mailing Address - State:MS
Mailing Address - Zip Code:38824-0366
Mailing Address - Country:US
Mailing Address - Phone:662-365-5610
Mailing Address - Fax:662-365-5611
Practice Address - Street 1:809 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-1309
Practice Address - Country:US
Practice Address - Phone:662-728-7218
Practice Address - Fax:662-728-7228
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT4379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist