Provider Demographics
NPI:1346427218
Name:GOINS, JACALYN RENEA (DPT)
Entity type:Individual
Prefix:MRS
First Name:JACALYN
Middle Name:RENEA
Last Name:GOINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:JACALYN
Other - Middle Name:RENEA
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5822 LYONS VIEW PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6471
Mailing Address - Country:US
Mailing Address - Phone:865-588-6358
Mailing Address - Fax:865-909-9949
Practice Address - Street 1:5822 LYONS VIEW PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6471
Practice Address - Country:US
Practice Address - Phone:865-588-6358
Practice Address - Fax:865-909-9949
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist