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Individual

MRS. JENNIFER KNICKERBOCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1653 MOORESVILLE HWY, LEWISBURG, TN 37091-2005
(931) 359-4506
Mailing address
2816 BLOOMFIELD DR, THOMPSONS STATION, TN 37179-5108
(615) 794-8088

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
821
TN

Other

Enumeration date
01/03/2007
Last updated
07/08/2007
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