Provider Demographics
NPI:1851076277
Name:HASH, MICHAEL TODD
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TODD
Last Name:HASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 ARROWHEAD TRL
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-7003
Mailing Address - Country:US
Mailing Address - Phone:865-405-0575
Mailing Address - Fax:
Practice Address - Street 1:249 ARROWHEAD TRL
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-7003
Practice Address - Country:US
Practice Address - Phone:865-405-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5316225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant