Provider Demographics
NPI:1023509429
Name:POWELL, JANZEN LEIGH (ATC)
Entity type:Individual
Prefix:
First Name:JANZEN
Middle Name:LEIGH
Last Name:POWELL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 PHILPOT RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7028
Mailing Address - Country:US
Mailing Address - Phone:931-580-6631
Mailing Address - Fax:
Practice Address - Street 1:165 PHILPOT RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7028
Practice Address - Country:US
Practice Address - Phone:931-580-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer