Provider Demographics
NPI:1124315023
Name:ZENO, TIFFANY LYNN (PT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNN
Last Name:ZENO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-8930
Mailing Address - Fax:
Practice Address - Street 1:2913 BOONES CREEK RD STE 1
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-4997
Practice Address - Country:US
Practice Address - Phone:234-232-0688
Practice Address - Fax:734-542-0220
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015539225100000X
TN11576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist