MEDICARE: MS. JENNY L DOZA 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
1	225100000X	Physical Therapist	3880	TN

General Provider Information

NPI Number	:	1083798862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNY L DOZA PT

Provider Business Mailing Address
First Line	:	PO BOX 405827
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-5800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 EXETER RD
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-3966
Country	:	US
Telephone Number	:	901-757-1350
Fax Number	:	901-757-3496

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	10/20/2016

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