Individual
ANTHONY JACARUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
406 ROY MARTIN RD STE 9, GRAY, TN 37615-2245
(423) 477-1101
Mailing address
296 JESSICAS WAY, JOHNSON CITY, TN 37615-3079
(917) 853-9763
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
018884-1
NY
225100000X
Physical Therapist
Primary
14601
TN
Other
Enumeration date
03/28/2012
Last updated
03/13/2024
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