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Individual

MARY A TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
7540 DANNAHER WAY, SUITE 200, POWELL, TN 37849-4013
(865) 947-4034
Mailing address
7540 DANNAHER WAY, SUITE 200, POWELL, TN 37849-4013

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000004711
TN

Other

Enumeration date
10/06/2008
Last updated
10/06/2008
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