Individual
MS. PHYLLIS A WARDLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
121 PHYSICIANS DR, JACKSON, TN 38305-6011
(731) 664-5050
Mailing address
148 HENDERSON RD, JACKSON, TN 38305-5913
(731) 424-1291
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0849
TN
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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