Basic Information
| Provider Information | |||||||||
| NPI: | 1740594647 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HELMS | ||||||||
| FirstName: | JAIME | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | MPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | |||||||||
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| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 232 SUNRISE AVE | ||||||||
| Address2: | |||||||||
| City: | HONESDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184311085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702518003 | ||||||||
| FaxNumber: | 5702518005 | ||||||||
| Practice Location | |||||||||
| Address1: | 232 SUNRISE AVE | ||||||||
| Address2: | |||||||||
| City: | HONESDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184311085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702518003 | ||||||||
| FaxNumber: | 5702518005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2010 | ||||||||
| LastUpdateDate: | 08/03/2010 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | PT020818 | PA | Y | Other Service Providers | Specialist |
No ID Information.