Individual
MRS. JOY ANN JANSEN WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
629 GALLAHER RD, KINGSTON, TN 37763-4215
(865) 376-3416
(865) 376-3532
Mailing address
629 GALLAHER RD, KINGSTON, TN 37763-4215
(865) 376-3416
(865) 376-3532
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3765
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316076268
NPI
TN
01
—
1700316213
NPI
—
Enumeration date
01/23/2020
Last updated
01/23/2020
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