Clifton Lee Hackett, A.A.S.

Individual provider Active NPI Physical Therapy Assistant · Red Boiling Springs, TN

NPI 1427428101 · NPPES record last updated Oct 6, 2015

Key facts

NPI
1427428101
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
6143 (TN)
Practice address
309 Main St
Red Boiling Springs, TN 37150-2149
Phone
(615) 699-2304
NPI assigned
Oct 6, 2015
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
Credentials
Associate of Applied Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 6143 TN Yes

Addresses

Primary practice location

309 Main St
Red Boiling Springs, TN 37150-2149

Mailing address

309 Main St
Red Boiling Springs, TN 37150-2149

Other providers in Red Boiling Springs, TN

All providers in Red Boiling Springs, TN · Physical Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.