Individual
MARIA DIANE GERSAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7070 HIGHWAY 64, OAKLAND, TN 38060-3208
(901) 465-9191
(901) 465-9323
Mailing address
PO BOX 908, SOMERVILLE, TN 38068-0908
(901) 465-9191
(901) 465-9323
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3307
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4042615
BCBS PROVIDER NUM
TN
Enumeration date
07/13/2006
Last updated
08/15/2016
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