Provider Demographics
NPI:1285123935
Name:WINKLER, JASON MICHAEL (PTA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:MICHAEL
Last Name:WINKLER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5302
Mailing Address - Country:US
Mailing Address - Phone:615-591-7676
Mailing Address - Fax:615-591-7876
Practice Address - Street 1:347 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5302
Practice Address - Country:US
Practice Address - Phone:615-591-7676
Practice Address - Fax:615-591-7876
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5370225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant