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General NPI Number Information
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NPI Number | 1427778711
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Entity Type | Individual
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Provider Name | DEBORAH HAGGARD PTA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 1116 N MAIN ST
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City | SHELBYVILLE
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State | TN
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Zip | 37160-2310
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Country | US
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Telephone | 615-931-0027
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Fax |
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Provider Business Mailing Address
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Address Line | 4149 JENSOME LN
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City | FRANKLIN
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State | TN
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Zip | 37064-1163
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Country | US
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Telephone | 615-631-3196
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1980
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License Number State | TN
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