Jon-Marc Gowan, PTA
Individual provider Active NPI Physical Therapy Assistant · Milan, TN
NPI 1669948311 · NPPES record last updated Oct 21, 2018
Key facts
- NPI
- 1669948311
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 6257 (TN)
- Practice address
- 8017 Dogwood LN
Milan, TN 38358-6805 - Phone
- (731) 686-8373
- NPI assigned
- Oct 21, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 6257 | TN | Yes |
Addresses
Primary practice location
8017 Dogwood LN
Milan, TN 38358-6805
Mailing address
3935 Highway 70
Cedar Grove, TN 38321-7437
Phone (731) 676-3788
Other providers in Milan, TN
- Robert M Fields
- Flippin Drug Company, Inc
- Robert Fly
- FPM LLC
- Gibson County Podiatry LLC
- Kristen Nicole Gray
- James Groves
- Karon P Harrison
- William Hudson Harrison
- Brittany Danielle Hawk
All providers in Milan, 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 Oct 21, 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.