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General NPI Number Information
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NPI Number | 1144066473
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Entity Type | Individual
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Provider Name | JACOB STOREY PT
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Gender | Male
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Dates
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Enumeration Date | 07/05/2024
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Last Update Date | 09/22/2024
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Provider Practice Location Address
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Address Line | 3601 THE VANDERBILT CLINIC
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City | NASHVILLE
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State | TN
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Zip | 37232-3606
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Country | US
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Telephone | 615-322-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3841 GREEN HILLS VILLAGE DR STE 200
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City | NASHVILLE
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State | TN
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Zip | 37215-2691
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Country | US
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Telephone | 615-322-6842
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15560
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License Number State | TN
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