Provider Demographics
NPI:1578078069
Name:JARBOE, AMITY (PT)
Entity Type:Individual
Prefix:
First Name:AMITY
Middle Name:
Last Name:JARBOE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MED PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6310
Mailing Address - Country:US
Mailing Address - Phone:931-538-3755
Mailing Address - Fax:931-538-3756
Practice Address - Street 1:235 MED PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6310
Practice Address - Country:US
Practice Address - Phone:931-538-3755
Practice Address - Fax:931-538-3756
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN467955225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist