Provider Demographics
NPI:1619299807
Name:EARLY, NATONYA QUENISE (MSPT,PHD(C))
Entity Type:Individual
Prefix:MRS
First Name:NATONYA
Middle Name:QUENISE
Last Name:EARLY
Suffix:
Gender:F
Credentials:MSPT,PHD(C)
Other - Prefix:MS
Other - First Name:NATONYA
Other - Middle Name:QUENISE
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT,PHD(C)
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:1106 FOUNTAIN PARK CIR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4806
Practice Address - Country:US
Practice Address - Phone:912-262-2151
Practice Address - Fax:912-262-2754
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist