Provider Demographics
NPI:1386037307
Name:POWERS, PENNY J
Entity Type:Individual
Prefix:MS
First Name:PENNY
Middle Name:J
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PENNY
Other - Middle Name:J
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, MS, ATP
Mailing Address - Street 1:1215 21ST AVE S
Mailing Address - Street 2:MCE SOUTH TOWER SUITE 9211
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-5677
Mailing Address - Country:US
Mailing Address - Phone:615-936-5040
Mailing Address - Fax:615-936-5699
Practice Address - Street 1:1215 21ST AVE S
Practice Address - Street 2:MCE SOUTH TOWER SUITE 9211
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-5677
Practice Address - Country:US
Practice Address - Phone:615-936-5040
Practice Address - Fax:615-936-5699
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15312251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology