Provider Demographics
NPI:1952397820
Name:CHANDLER, JEFFREY GARLAND (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:GARLAND
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 FOX RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-9419
Mailing Address - Country:US
Mailing Address - Phone:865-692-5114
Mailing Address - Fax:865-692-5115
Practice Address - Street 1:111 FOX RD
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-9419
Practice Address - Country:US
Practice Address - Phone:865-692-5114
Practice Address - Fax:865-692-5115
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3658547Medicaid
TN3658547OtherBCBS
TN3658547OtherMCRR
TN4414461OtherAETNA