Individual
MS. ALICE C. ARCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
629 W ELK AVE, ELIZABETHTON, TN 37643-2559
(423) 722-2062
(423) 722-2063
Mailing address
135 UNAKA VIEW RD, JOHNSON CITY, TN 37601-5119
(423) 928-1026
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000002449
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446517
—
TN
Enumeration date
03/05/2007
Last updated
07/08/2007
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