Melissa Suzann Davenport, PTA
Individual provider Active NPI Physical Therapy Assistant · Carthage, TN
NPI 1497040778 · NPPES record last updated Jun 14, 2011
Key facts
- NPI
- 1497040778
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 02937 (TN)
- Practice address
- 112 Health Care Dr
Carthage, TN 37030-1168 - Phone
- (615) 735-0569
- NPI assigned
- Jun 14, 2011
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02937 | TN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 02937 | TN | Yes |
Addresses
Primary practice location
112 Health Care Dr
Carthage, TN 37030-1168
Mailing address
669 Trammel Rd
Lebanon, TN 37090-0778
Phone (615) 969-3375
Other providers in Carthage, TN
- Lauren Lewis Cooper
- Sarah Amelia Cowan
- Melanie Cripps
- Cumberland Anesthesia, PLLC
- Colleen Curtis
- John M. Dedmon
- Sydnea Alexus Dickens
- Grace Leslie Dillard
- Davin Apple Dillehay
- Jennefer Doris Dixon
All providers in Carthage, TN · Physical Therapy Assistant 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 14, 2011. 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.