Provider Demographics
NPI:1427170992
Name:STITT, CORINNA LYNN (PTA)
Entity type:Individual
Prefix:
First Name:CORINNA
Middle Name:LYNN
Last Name:STITT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4915
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:1609 N COALTER ST
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2552
Practice Address - Country:US
Practice Address - Phone:540-213-1320
Practice Address - Fax:540-213-1323
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20313225200000X
PATE001208L225200000X
VA2306605041225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PATE001208LOtherPHYSICAL THERAPIST ASSIST
FLPTA20313OtherPHYSICAL THERAPIST ASSIST