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NPI Code Detail

MEDICARE: TAMMY JO PATTON PTA

MEDICARE: TAMMY JO PATTON 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
1225200000XPhysical Therapy Assistant2932TN

General Provider Information

NPI Number : 1902980659
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY JO PATTON PTA
Provider Business Mailing Address
First Line : 1435 LYNWOOD DR
Second Line :
City : TROY
State : TN
Zip : 38260-3476
Country : US
Telephone Number : 731-536-9912
Fax Number : 731-536-0104
Provider Business Practice Location Address
First Line : 1630 E REELFOOT AVE
Second Line :
City : UNION CITY
State : TN
Zip : 38261-6021
Country : US
Telephone Number : 731-885-8095
Fax Number : 731-885-5042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 07/08/2007

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