Stephen Lyle Archer, PTA

Individual provider Active NPI Physical Therapy Assistant · Greeneville, TN

NPI 1013203629 · NPPES record last updated Jun 22, 2011

Key facts

NPI
1013203629
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
0000004501 (TN)
Practice address
4850 East Andrew Johnson Highway
Greeneville, TN 37745-3098
Phone
(423) 787-6800
NPI assigned
Jun 22, 2011
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

State licenses

LicenseStateTypeSpecialty
0000004501TNMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0000004501 TN Yes

Addresses

Primary practice location

4850 East Andrew Johnson Highway
Greeneville, TN 37745-3098

Mailing address

4850 E Andrew Johnson Hwy
Greeneville, TN 37745-3098
Phone (423) 787-6800

Other providers in Greeneville, TN

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

Sources for this page

Verify at the official NPI Registry.