Individual
MR. HAYDEN ROSS ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
550 N SPRING ST, SPARTA, TN 38583
(931) 837-2221
Mailing address
4129 NEW HOME RD, SMITHVILLE, TN 37166-6409
(615) 598-2483
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000006339
TN
Other
Enumeration date
09/12/2016
Last updated
03/08/2019
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