Chris Haney

Individual provider Active NPI Physical Therapy Assistant · Cleveland, TN

NPI 1902960412 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1902960412
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2504 (TN)
Practice address
2700 Westside Dr NW
Suite 103
Cleveland, TN 37312-3699
Phone
(423) 614-0097
NPI assigned
Dec 20, 2006
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

State licenses

LicenseStateTypeSpecialty
2504TNMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2504 TN Yes

Addresses

Primary practice location

2700 Westside Dr NW
Suite 103
Cleveland, TN 37312-3699

Mailing address

2700 Westside Dr NW
Suite 103
Cleveland, TN 37312-3699
Phone (423) 614-0097

Other providers in Cleveland, TN

All providers in Cleveland, TN · Physical Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.