Individual
JACQUELINE ANN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
309 EDGEWOOD AVE, CLINTON, TN 37716-2822
(865) 414-2881
Mailing address
309 EDGEWOOD AVE, CLINTON, TN 37716-2822
(865) 414-2881
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3048
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3548
DEPARTMENT OF HEALTH
TN
01
—
4578316
DOH
TN
Enumeration date
10/14/2022
Last updated
10/14/2022
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