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Individual

JASON R STOOKSBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
102 N MASSACHUSETTS AVE, SUITE 6, LA FOLLETTE, TN 37766-2847
(423) 907-0064
(423) 907-0065
Mailing address
102 N MASSACHUSETTS AVE, SUITE 6, LA FOLLETTE, TN 37766-2847
(423) 907-0064
(423) 907-0065

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7046
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3647224
TN
Enumeration date
10/18/2006
Last updated
03/05/2008
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