Provider Demographics
NPI:1093232779
Name:FARNSWORTH, MACEY NICOLE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:MACEY
Middle Name:NICOLE
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:MACEY
Other - Middle Name:NICOLE
Other - Last Name:MCKENZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-8930
Mailing Address - Fax:423-254-5217
Practice Address - Street 1:311 CONGRESS PKWY N STE 800
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-1697
Practice Address - Country:US
Practice Address - Phone:423-744-0890
Practice Address - Fax:423-744-0849
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist