Provider Demographics
NPI:1104063353
Name:CARNATHAN, JAMIE T (PT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:T
Last Name:CARNATHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:T
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2100 EXETER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3966
Mailing Address - Country:US
Mailing Address - Phone:901-522-6440
Mailing Address - Fax:901-757-2507
Practice Address - Street 1:2100 EXETER RD STE 200
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3966
Practice Address - Country:US
Practice Address - Phone:901-522-6440
Practice Address - Fax:901-757-2507
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000001714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist