MEDICARE: ELIJAH HARVEY PTA

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	225200000X	Physical Therapy Assistant	7891	TN

General Provider Information

NPI Number	:	1437006269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIJAH HARVEY PTA

Provider Business Mailing Address
First Line	:	2626 WALKER RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-1116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5314 VILLAGE GARDEN DR
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-9006
Country	:	US
Telephone Number	:	423-650-8768
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “ ELIJAH HARVEY PTA” Practice Location

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