Individual
JASE BLAKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
118 DEVONSHIRE SQ STE 7, JACKSON, TN 38305-2267
(731) 660-6902
Mailing address
2071 STAGE RD, SCOTTS HILL, TN 38374-5057
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5433
TN
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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