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NPI Code Detail

MEDICARE: MISS JENNIFER LYNN SUMMEY PTA

MEDICARE:  MISS JENNIFER LYNN SUMMEY  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
1225200000XPhysical Therapy Assistant3028TN

General Provider Information

NPI Number : 1689898769
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER LYNN SUMMEY PTA
Provider Business Mailing Address
First Line : 2670 ASHEVILLE HWY
Second Line :
City : GREENEVILLE
State : TN
Zip : 37743-5913
Country : US
Telephone Number : 423-639-0470
Fax Number :
Provider Business Practice Location Address
First Line : 801 E MCKEE ST
Second Line :
City : GREENEVILLE
State : TN
Zip : 37743-6010
Country : US
Telephone Number : 423-638-9226
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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Directions to “ MISS JENNIFER LYNN SUMMEY PTA” Practice Location

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