Zackary Austin

Individual provider Active NPI Physical Therapy Assistant · Humboldt, TN

NPI 1003440678 · NPPES record last updated Feb 23, 2020

Key facts

NPI
1003440678
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
7369 (TN)
Practice address
2865 E Main St
Humboldt, TN 38343-3070
Phone
(731) 784-8405
NPI assigned
Feb 23, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 7369 TN Yes

Addresses

Primary practice location

2865 E Main St
Humboldt, TN 38343-3070

Mailing address

61 Riley CV
Medina, TN 38355-9812
Phone (731) 819-1659

Other providers in Humboldt, TN

All providers in Humboldt, TN · Physical Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.