Individual
MR. JEFFREY PAUL SODEMANN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1043 EXECUTIVE DRIVE, SUITE 101, HIXSON, TN 37343-3998
(423) 870-6004
(423) 870-6005
Mailing address
1043 EXECUTIVE DRIVE, SUITE 101, HIXSON, TN 37343-3998
(423) 870-6004
(423) 870-6005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000000341
TN
225100000X
Physical Therapist
PT000554
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3110918
BLUECROSS BLUESHILD OF TN
TN
Enumeration date
06/02/2006
Last updated
07/08/2007
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