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NPI Code Detail

MEDICARE: ANN ELIZABETH UNDERWOOD MSPT

MEDICARE: ANN ELIZABETH UNDERWOOD MSPT
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 Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23156797OTHERTNBCBST - GROUP NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962458885
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN ELIZABETH UNDERWOOD MSPT
Provider Business Mailing Address
First Line : 8823 PRODUCTION LN
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-6511
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 3575 KEITH ST NW
Second Line : STE 205
City : CLEVELAND
State : TN
Zip : 37312-4324
Country : US
Telephone Number : 423-559-0444
Fax Number : 423-559-0103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 07/28/2022

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Directions to “ ANN ELIZABETH UNDERWOOD MSPT” Practice Location

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