Provider Demographics
NPI:1578877627
Name:HAVILAND, SUMMER LEE (DPT)
Entity Type:Individual
Prefix:DR
First Name:SUMMER
Middle Name:LEE
Last Name:HAVILAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:SUMMER
Other - Middle Name:LEE
Other - Last Name:WILKERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7003 SHALLOWFORD RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6722
Mailing Address - Country:US
Mailing Address - Phone:423-888-6238
Mailing Address - Fax:423-220-8238
Practice Address - Street 1:7003 SHALLOWFORD RD STE 102
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6722
Practice Address - Country:US
Practice Address - Phone:423-888-6238
Practice Address - Fax:423-220-8238
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-31
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 2251E1200X, 2251G0304X, 2251S0007X, 2251X0800X
TN15153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic