Provider Demographics
NPI:1275998148
Name:SROGA, JOANNA (DPT, PT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:SROGA
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-356-0710
Mailing Address - Fax:615-356-0711
Practice Address - Street 1:5002 CROSSINGS CIR STE 320
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-8536
Practice Address - Country:US
Practice Address - Phone:615-758-9129
Practice Address - Fax:615-758-9130
Is Sole Proprietor?:No
Enumeration Date:2015-12-20
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12969225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist