Individual
JODI LYNN JAGODZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
501 ADESSA PKWY, SUITE A140, LENOIR CITY, TN 37771-6725
(865) 988-7610
(865) 988-6636
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446652
—
TN
01
—
3156797
BCBST GROUP NUMBER
TN
Enumeration date
06/02/2006
Last updated
01/27/2011
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