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Individual

MS. JENNIFER E. SPADAFORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
8904 CROSS PARK DR, KNOXVILLE, TN 37923-4703
(865) 690-2671
(865) 690-6445
Mailing address
PO BOX 32709, KNOXVILLE, TN 37930-2709
(865) 558-6484
(865) 584-4037

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
6404
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3654282
TN
01
4022173
BLUE CROSS
TN
Enumeration date
05/12/2006
Last updated
10/08/2007
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