Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 8208 | TN |
NPI | 1093836595 |
---|---|
Provider Name | Mrs. Greta P. Roof |
First Address | Franklin, TN 37064-1452 |
Second Address | Franklin, TN 37064-1452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/11/2017 |