Individual
JACQUELYN MITCHELL FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
210 OAK ST N, SWEETWATER, TN 37874-2833
(423) 337-7500
(423) 337-7504
Mailing address
210 OAK ST N, SWEETWATER, TN 37874-2833
(423) 337-7500
(423) 337-7504
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000001175
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123087
BLUE CROSS/BLUE SHIELD
TN
Enumeration date
10/19/2006
Last updated
07/08/2007
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