Provider Demographics
NPI:1245906908
Name:HENSLEY, CONNER J (PT, DPT)
Entity type:Individual
Prefix:
First Name:CONNER
Middle Name:J
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 LEE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37345-3033
Mailing Address - Country:US
Mailing Address - Phone:423-368-8476
Mailing Address - Fax:
Practice Address - Street 1:1001 HUNTSVILLE HWY
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-3441
Practice Address - Country:US
Practice Address - Phone:931-433-0273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12689225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist