Individual
JIMMY CROSNOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
616 W FOREST AVE, JACKSON, TN 38301-3902
(731) 422-0330
(731) 422-0220
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-8697
(731) 422-5743
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1708
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3651919
—
TN
Enumeration date
03/14/2006
Last updated
10/29/2008
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