Provider Demographics
NPI:1427725118
Name:TURBYVILLE, ANECIA
Entity type:Individual
Prefix:
First Name:ANECIA
Middle Name:
Last Name:TURBYVILLE
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 1:1160 HIGHWAY 124
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:38230-3606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1160 HIGHWAY 124
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:TN
Practice Address - Zip Code:38230-3606
Practice Address - Country:US
Practice Address - Phone:270-804-3661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4109225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant