Jennifer Sharp Bryan

Individual provider Active NPI Occupational Therapy Assistant · Ardmore, TN

NPI 1760726129 · NPPES record last updated Nov 23, 2012

Key facts

NPI
1760726129
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
857 (TN)
Practice address
25385 Main St
Ardmore, TN 38449-3155
Phone
(931) 427-2143
NPI assigned
Nov 23, 2012
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

State licenses

LicenseStateTypeSpecialty
857TNMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 857 TN Yes

Addresses

Primary practice location

25385 Main St
Ardmore, TN 38449-3155

Mailing address

25385 Main St
Ardmore, TN 38449-3155
Phone (931) 427-2143

Other providers in Ardmore, TN

All providers in Ardmore, TN · Occupational Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.