Carlo Cereno
Individual provider Active NPI Physical Therapist · Harriman, TN
NPI 1154815934 · NPPES record last updated Jun 15, 2018
Key facts
- NPI
- 1154815934
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 9709 (TN)
- Practice address
- 257 Patton LN
Harriman, TN 37748-8618 - Phone
- (662) 680-3148
- Fax
- (662) 620-9890
- NPI assigned
- Jun 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9709 | TN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9709 | TN | Yes |
Addresses
Primary practice location
257 Patton LN
Harriman, TN 37748-8618
Mailing address
PO Box 3667
Tupelo, MS 38803-3667
Phone (662) 680-3148
Other providers in Harriman, TN
- Thomas A Browning
- Monica Kay Burgess
- Whitney Capshaw
- Ramona Carpenter
- Trisha Ann Carver
- Benjamin Michael Chalstrom
- Champion Physical Therapy LLC Halls
- Geri Marie Childs
- Cassandra Claborn
- Joshua David Clark-Fuqua
All providers in Harriman, 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 Jun 15, 2018. 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.