Provider Demographics
NPI:1013588391
Name:MCGINNIS, JOANNE SHURU-TAN (DPT)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:SHURU-TAN
Last Name:MCGINNIS
Suffix:
Gender:
Credentials:DPT
Other - Prefix:MISS
Other - First Name:JOANNE
Other - Middle Name:SHURU
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1035 COLEMAN RD APT 7115
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-6703
Mailing Address - Country:US
Mailing Address - Phone:615-974-6435
Mailing Address - Fax:
Practice Address - Street 1:3056 MILES JOHNSON PKWY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-4564
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11751225100000X
CA300192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist