Provider Demographics
NPI:1366304396
Name:JO, MIHYUN
Entity type:Individual
Prefix:
First Name:MIHYUN
Middle Name:
Last Name:JO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 DILL LN APT 821
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-5828
Mailing Address - Country:US
Mailing Address - Phone:917-474-1739
Mailing Address - Fax:
Practice Address - Street 1:538 BRANDIES CIR STE 101
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-8421
Practice Address - Country:US
Practice Address - Phone:615-624-7427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-28
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist