Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 97 | TN |
N | 2251P0200X | Physical Therapist - Pediatrics | 97 | TN |
NPI | 1093808875 |
---|---|
Provider Name | Janice Jones |
First Address | Hixson, TN 37343-2204 |
Second Address | Chattanooga, TN 37421-2166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |