Provider Demographics
NPI:1952478992
Name:BALL, JEANNE KAY (PTA)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:KAY
Last Name:BALL
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 1:93 SHARON DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NHC MCMINNEVILLE
Practice Address - Street 2:928 OLD SMITHVILLE RD
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110
Practice Address - Country:US
Practice Address - Phone:931-473-8431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN885225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant