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NPI Code Detail

MEDICARE: MS. PENNY CAROLYN TIPPS PT

MEDICARE: MS. PENNY CAROLYN TIPPS PT
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
1225100000XPhysical TherapistPT1688TN

General Provider Information

NPI Number : 1003016213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PENNY CAROLYN TIPPS PT
Provider Business Mailing Address
First Line : 1801 N JACKSON ST
Second Line :
City : TULLAHOMA
State : TN
Zip : 37388-8259
Country : US
Telephone Number : 931-393-7964
Fax Number : 931-455-6308
Provider Business Practice Location Address
First Line : 1801 N JACKSON ST
Second Line :
City : TULLAHOMA
State : TN
Zip : 37388-8259
Country : US
Telephone Number : 931-393-7964
Fax Number : 931-455-6308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2007
Last Update Date : 07/25/2007

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Directions to “ MS. PENNY CAROLYN TIPPS PT” Practice Location

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