Jacquelyn Mitchell Fox, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Sweetwater, TN
NPI 1417039876 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1417039876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT0000001175 (TN)
- Practice address
- 210 Oak St N
Sweetwater, TN 37874-2833 - Phone
- (423) 337-7500
- Fax
- (423) 337-7504
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- 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 |
|---|---|---|---|
| PT0000001175 | TN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0000001175 | TN | Yes |
Addresses
Primary practice location
210 Oak St N
Sweetwater, TN 37874-2833
Mailing address
210 Oak St N
Sweetwater, TN 37874-2833
Phone (423) 337-7500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0123087 | Other | TN | BLUE CROSS/BLUE SHIELD |
Other providers in Sweetwater, TN
- First Care Health PLLC
- First Care Health, PLLC
- Foster Family Eyecare, PLLC
- Macy H Foster
- Thomas Alan Foster
- John Michael Fox
- Frederick a. Klein, MD., PC
- Christal Dawn Frerichs
- Aminee Frye
- Jennifer Gallagher
All providers in Sweetwater, 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.