MEDICARE: HANNAH D KIZIAH DPT

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

General Provider Information

NPI Number	:	1619492055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH D KIZIAH DPT

Provider Business Mailing Address
First Line	:	6397 LEE HWY STE 300
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-2564
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3034 N CENTER ST STE A
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-1298
Country	:	US
Telephone Number	:	828-256-4313
Fax Number	:	828-256-4318

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

Provider Enumeration Date	:	08/07/2017
Last Update Date	:	08/07/2017

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