| Mossy Creek Rehab | |
|
1405 S Sizer Ave, Jefferson City, TN 37760-2436 | |
| (865) 246-8090 | |
| Not Available |
| Full Name | Mossy Creek Rehab |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 1405 S Sizer Ave, Jefferson City, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427386200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT0000001151 (Tennessee) | Primary |
| Provider Name | Robert A Matijevich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952639916 PECOS PAC ID: 7618010596 Enrollment ID: I20100201000081 |
| Provider Name | Lindsay Matijevich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356794887 PECOS PAC ID: 0244622009 Enrollment ID: I20220128000487 |
| Mailing Address | Practice Location Address |
|---|---|
| Mossy Creek Rehab 1405 S Sizer Ave, Jefferson City, TN 37760-2436 Ph: (865) 246-8090 | Mossy Creek Rehab 1405 S Sizer Ave, Jefferson City, TN 37760-2436 Ph: (865) 246-8090 |
Jason Curtis Moore, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 102 E Commerce Ct, Jefferson City, TN 37760 Phone: 865-475-3101 Fax: 865-475-9213 | |
Fiorello Erico Pacia Jr., PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 102 E Commerce Ct, Jefferson City, TN 37760 Phone: 865-475-3101 Fax: 865-475-9012 | |
Andrew Fultz, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 102 E Commerce Ct, Jefferson City, TN 37760 Phone: 865-475-3101 Fax: 865-475-9213 | |
Sydnie Jordan Hodge, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 283 W Broadway Blvd, Jefferson City, TN 37760 Phone: 865-475-9037 | |
John Duty, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 646 E Broadway Blvd, Jefferson City, TN 37760 Phone: 865-471-6890 | |
Mrs. Milagros Pacia, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 102 E Commerce Ct, Jefferson City, TN 37760 Phone: 865-475-3101 Fax: 865-475-9213 |