Colby Lee Cross, PTA
Individual provider Active NPI Physical Therapy Assistant · Sparta, TN
NPI 1508350109 · NPPES record last updated Jun 18, 2018
Key facts
- NPI
- 1508350109
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 6774 (TN)
- Practice address
- 34 Gracey St
Sparta, TN 38583-2046 - Phone
- (931) 836-2211
- NPI assigned
- Jun 18, 2018
- Sex
- Male
- 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 |
|---|---|---|---|
| 6774 | TN | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 6774 | TN | Yes |
Addresses
Primary practice location
34 Gracey St
Sparta, TN 38583-2046
Mailing address
2170 Iris LN
Rickman, TN 38580-2162
Phone (931) 265-7594
Other providers in Sparta, TN
- County of White Superintendent of Schools
- Kevin W Crawford
- Angela Cremeans
- Daniel Justin Cripps
- Olivia Hamby Crosland
- Thomas Eugene Crosslin Jr.
- Cumberland Family Care PC
- Cumberland Home Doctors, LLC
- Cumberland Physical Therapy and Rehabilitation
- Cumberland Plateau Surgical Associates
All providers in Sparta, 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 18, 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.