Individual
MR. JODY ERIC MUSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
110 E CENTER ST, KINGSPORT, TN 37660-4230
(423) 765-1611
(423) 765-1612
Mailing address
406 ROY MARTIN RD, SUITE 9, GRAY, TN 37615-2244
(423) 477-1101
(423) 477-1102
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6591
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4293094
BLUE CROSS BLUE SHIELD TN
TN
05
—
4293094
—
TN
05
—
Q004105
—
TN
Enumeration date
12/08/2010
Last updated
01/16/2020
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