Provider Demographics
NPI:1417613290
Name:JONES, TAMMY MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:TAMMIE
Other - Middle Name:MARIE
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4045 SEQUOIA TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-5185
Mailing Address - Country:US
Mailing Address - Phone:256-577-0210
Mailing Address - Fax:
Practice Address - Street 1:4045 SEQUOIA TRL
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-5185
Practice Address - Country:US
Practice Address - Phone:256-577-0210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000007400225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant