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Individual

MARTINA HERNANDEZ PACO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
4982 LEBANON PIKE, SUITE C, OLD HICKORY, TN 37138-4107
(615) 232-9201
(615) 232-9202
Mailing address
3017 MELBOURNE CT E, MOUNT JULIET, TN 37122-7540
(615) 232-9201
(615) 232-9202

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2706
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3648498
TN
01
4100643
BILLING NUMBER
TN
Enumeration date
02/20/2007
Last updated
07/09/2007
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