Sue Ellen Close
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Lewisburg, TN
NPI 1679040232 · NPPES record last updated Oct 31, 2018
Key facts
- NPI
- 1679040232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 489 (TN)
- Practice address
- 1653 Mooresville Hwy
Lewisburg, TN 37091-1413 - Phone
- (931) 359-4506
- Fax
- (931) 359-8139
- NPI assigned
- Oct 31, 2018
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 489 | TN | Yes |
Addresses
Primary practice location
1653 Mooresville Hwy
Lewisburg, TN 37091-1413
Mailing address
1653 Mooresville Hwy
Lewisburg, TN 37091-1413
Phone (931) 359-4506
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 489 | Other | TN | PHYSICAL THERPIST ASSISTANT |
Other providers in Lewisburg, TN
- Stephen Paul Chester
- John Sherman Childers Jr.
- Kelly Chitty
- Carolyn Ann Clark
- Laura Elizabeth Cline
- Latisha Carol Colburn
- Vicki L Coleman
- Community Development Center
- Adam Walton Cook
- Cook'S Family Dentistry
All providers in Lewisburg, TN · Physical Medicine & Rehabilitation Physician 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 31, 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.