Jennifer Keele Nogodula, P.T.

Individual provider Active NPI Physical Therapist · MC Minnville, TN

NPI 1508913153 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508913153
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
7062 (TN)
Practice address
928 Old Smithville Rd
MC Minnville, TN 37110-6805
Phone
(931) 473-8431
NPI assigned
Jan 5, 2007
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7062 TN Yes

Addresses

Primary practice location

928 Old Smithville Rd
MC Minnville, TN 37110-6805

Mailing address

328 Riddle Rd
Manchester, TN 37355
Phone (931) 728-9192

Other providers in MC Minnville, TN

All providers in MC Minnville, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.