Individual
TAMMY MELLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
2301 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2959
(423) 566-2250
(423) 566-5896
Mailing address
2301 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2959
(423) 566-2250
(423) 566-5896
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT859
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT859
PHYSICAL THERAPY LICENSE
TN
Enumeration date
02/25/2008
Last updated
02/25/2008
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