Provider Demographics
NPI:1932645892
Name:DENTON, TASHA (PT)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:
Last Name:DENTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:257 BANCORP SOUTH PKWY
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-7582
Mailing Address - Country:US
Mailing Address - Phone:731-660-8781
Mailing Address - Fax:731-660-8739
Practice Address - Street 1:38 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-2544
Practice Address - Country:US
Practice Address - Phone:731-772-5213
Practice Address - Fax:731-772-8209
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5796225200000X
TN14244225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant