Shaw, Jessica Lori

Shaw, Jessica Lori is an individual health care provider with primary practice located at 2415 Mccallie Ave , Chattanooga TN 37404-3322. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Shaw, Jessica Lori can be contacted via phone (423) 622-6200.

Contact Information

Primary practice address
2415 Mccallie Ave Chattanooga TN 37404-3322
Phone: (423) 622-6200
Fax: (423) 697-2025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT007002 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 6258 Tennessee

Profile Details

NPI number 1689670895
LBN Legal business name Shaw, Jessica Lori
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Oct 30th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689670895 NPPES
Tennessee Other 4021800 BCBS
Tennessee Other TN0100 BCBS

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