Individual
JALEESA BLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
6600 HIGHWAY 195, SOMERVILLE, TN 38068-8202
(901) 371-1925
Mailing address
6600 HIGHWAY 195, SOMERVILLE, TN 38068-8202
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6622
TN
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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