Healthcare Provider Details

I. General information

NPI: 1861659344
Provider Name (Legal Business Name): MARDYS MARIE HEWGLEY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 EDWARD CURD LN
FRANKLIN TN
37067-5791
US

IV. Provider business mailing address

3000 EDWARD CURD LN
FRANKLIN TN
37067-5791
US

V. Phone/Fax

Practice location:
  • Phone: 616-791-2630
  • Fax: 615-791-2639
Mailing address:
  • Phone: 615-791-2630
  • Fax: 615-791-2639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number7172
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: