Provider Demographics
NPI:1639426463
Name:MCCAIG, CATHY JO (PT)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:JO
Last Name:MCCAIG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:JO
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1243 WHITEHALL ST
Mailing Address - Street 2:BOX 50
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3780
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:580 TENNESSEE AVE N
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-2624
Practice Address - Country:US
Practice Address - Phone:731-847-9228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3319225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist