Provider Demographics
NPI:1881977205
Name:HAGER, JESSAN AERIE (MPT)
Entity type:Individual
Prefix:MR
First Name:JESSAN
Middle Name:AERIE
Last Name:HAGER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 NEW LEICESTER HWY
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-1917
Mailing Address - Country:US
Mailing Address - Phone:828-225-3838
Mailing Address - Fax:828-225-3839
Practice Address - Street 1:149 NEW LEICESTER HWY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-1917
Practice Address - Country:US
Practice Address - Phone:828-225-3838
Practice Address - Fax:828-225-3839
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist