Provider Demographics
NPI:1467824532
Name:CLEMENTS, JOY RUCKER (PT)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:RUCKER
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:CELESTE
Other - Last Name:RUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2020 GUNBARREL RD
Mailing Address - Street 2:STE 408
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2663
Mailing Address - Country:US
Mailing Address - Phone:423-238-1127
Mailing Address - Fax:423-238-1277
Practice Address - Street 1:4964 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8071
Practice Address - Country:US
Practice Address - Phone:706-866-6414
Practice Address - Fax:706-866-6616
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10362225100000X
GAPT012387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist