Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 8918 | TN |
NPI | 1003109166 |
---|---|
Provider Name | Ann R Cupo |
First Address | Franklin, TN 37067-7269 |
Second Address | Hixson, TN 37343-7914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 25/11/2015 |