Provider Demographics
NPI:1346367463
Name:HUTSON, JOHN SHOFFNER (ATC,MSS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:SHOFFNER
Last Name:HUTSON
Suffix:
Gender:M
Credentials:ATC,MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 BROOKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8424
Mailing Address - Country:US
Mailing Address - Phone:615-373-2323
Mailing Address - Fax:
Practice Address - Street 1:1114 BROOKVIEW DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8424
Practice Address - Country:US
Practice Address - Phone:615-373-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer