Provider Demographics
NPI:1902980659
Name:PATTON, TAMMY JO (PTA)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:JO
Last Name:PATTON
Suffix:
Gender:F
Credentials:PTA
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Mailing Address - Street 1:1435 LYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:TN
Mailing Address - Zip Code:38260-3476
Mailing Address - Country:US
Mailing Address - Phone:731-536-9912
Mailing Address - Fax:731-536-0104
Practice Address - Street 1:1630 E REELFOOT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6021
Practice Address - Country:US
Practice Address - Phone:731-885-8095
Practice Address - Fax:731-885-5042
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN2932225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant