Provider Demographics
NPI:1467824532
Name:CLEMENTS, JOY RUCKER (PT)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:RUCKER
Last Name:CLEMENTS
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:CELESTE
Other - Last Name:RUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5808 NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4621
Mailing Address - Country:US
Mailing Address - Phone:843-991-8265
Mailing Address - Fax:
Practice Address - Street 1:4964 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8071
Practice Address - Country:US
Practice Address - Phone:706-866-6414
Practice Address - Fax:706-866-6616
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10362225100000X
GAPT012387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist