Amanda Jo Temple, MPT

Individual provider Active NPI Physical Therapist · Lookout Mountain, TN

NPI 1790989697 · NPPES record last updated Feb 4, 2011

Key facts

NPI
1790989697
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT7833 (TN)
Practice address
820 Scenic Hwy Ste B
Mountain Center Building
Lookout Mountain, TN 37350-1474
Phone
(423) 825-1393
Fax
(423) 825-6147
NPI assigned
Jun 13, 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)
Yes

State licenses

LicenseStateTypeSpecialty
PT7833TNMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT7833 TN Yes

Addresses

Primary practice location

820 Scenic Hwy Ste B
Mountain Center Building
Lookout Mountain, TN 37350-1474

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other identifiers

IdentifierTypeStateIssuer
03650060MedicaidTN

Other names

  • Amanda Jo Morris Former name

Other providers in Lookout Mountain, TN

All providers in Lookout Mountain, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.