MEDICARE: VANESSA STEWART PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	6895	TN

General Provider Information

NPI Number	:	1255019238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA STEWART PTA

Provider Business Mailing Address
First Line	:	5150 AIRLINE RD STE 400
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-8008
Country	:	US
Telephone Number	:	901-507-1250
Fax Number	:	901-507-1251

Provider Business Practice Location Address
First Line	:	5150 AIRLINE RD STE 400
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-8008
Country	:	US
Telephone Number	:	901-507-1250
Fax Number	:	901-507-1251

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	02/10/2025

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