Provider Demographics
NPI:1639378458
Name:GATGENS, ERIN MACKAY (LPT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MACKAY
Last Name:GATGENS
Suffix:
Gender:F
Credentials:LPT, DPT
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:MACKAY
Other - Last Name:EBELHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPT, DPT
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:423-238-3473
Practice Address - Street 1:889B BELL RD
Practice Address - Street 2:STE A-7A
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-3101
Practice Address - Country:US
Practice Address - Phone:423-717-6262
Practice Address - Fax:615-717-6890
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7863225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I659348Medicare PIN