Individual
JEANNETTE AUSTIN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1480 E 3RD ST, CHATTANOOGA, TN 37404-2434
(423) 622-2459
(423) 622-4879
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2958
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446652
—
TN
01
—
3156797
BCBST - GROUP NUMBER
TN
05
—
5441443
—
TN
Enumeration date
05/26/2006
Last updated
11/22/2011
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