IndividualActive
Anthony Jacaruso
NPI 1124394770 · Physical Therapist · Gray, TN
Provider details
- NPI number
- 1124394770
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 018884-1 (NY)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
406 Roy Martin Rd Ste 9
Gray, TN 37615-2245
Phone: (423) 477-1101
Approximate (ZIP-level) locationGet directions
Mailing address
296 Jessicas Way
Johnson City, TN 37615-3079
Registry dates
- Enumerated
- 2012-03-28
- Last updated
- 2024-03-13
- Certified
- 2024-03-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.