Jacqueline Cultra Gilliam, PT
Individual provider Active NPI Physical Therapist · Martin, TN
NPI 1083823959 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1083823959
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2484 (TN)
- Practice address
- 904 Templeton Rd
Martin, TN 38237-5633 - Phone
- (731) 588-0814
- Fax
- (731) 587-5012
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2484 | TN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2484 | TN | Yes |
Addresses
Primary practice location
904 Templeton Rd
Martin, TN 38237-5633
Mailing address
904 Templeton Rd
Martin, TN 38237-5633
Phone (731) 588-0814
Other providers in Martin, TN
- Gary Brown
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- Generations Health Assoc.,Inc.Dba Generations Mental Health Center
- Generations Health Association
- Generations- Gaithers, Inc.
- Valerie Anna Gilliland
- Stefanie Lea Gray
- Ashley Lynn Hall
- Rebecca Diane Hall
- David Martin Hamlin
All providers in Martin, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.