Provider Demographics
NPI:1134857022
Name:PRESNELL, JESSIE LEIGH (PTA)
Entity type:Individual
Prefix:MRS
First Name:JESSIE
Middle Name:LEIGH
Last Name:PRESNELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8024 BRICKYARD RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5325
Mailing Address - Country:US
Mailing Address - Phone:423-557-6346
Mailing Address - Fax:
Practice Address - Street 1:2435 JACKSBORO PIKE
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-2910
Practice Address - Country:US
Practice Address - Phone:423-566-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant