Hayden Ross Ervin, PTA

Individual provider Active NPI Physical Therapy Assistant · Sparta, TN

NPI 1013465772 · NPPES record last updated Mar 8, 2019

Key facts

NPI
1013465772
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA0000006339 (TN)
Practice address
550 N Spring St
Sparta, TN 38583
Phone
(931) 837-2221
NPI assigned
Sep 12, 2016
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
PTA0000006339TNMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA0000006339 TN Yes

Addresses

Primary practice location

550 N Spring St
Sparta, TN 38583

Mailing address

4129 New Home Rd
Smithville, TN 37166-6409
Phone (615) 598-2483

Other practice location 1

34 Gracey St
Sparta, TN 38583-2046
Phone (931) 836-2211

Other practice location 2

550 N Spring St
Sparta, TN 38583
Phone (931) 837-2221

Other providers in Sparta, TN

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

Sources for this page

Verify at the official NPI Registry.