Provider Demographics
NPI:1740002385
Name:TEAGUE, JEROME (DPT)
Entity type:Individual
Prefix:
First Name:JEROME
Middle Name:
Last Name:TEAGUE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 MEDICAL CENTER PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2594
Mailing Address - Country:US
Mailing Address - Phone:615-217-0259
Mailing Address - Fax:
Practice Address - Street 1:1725 MEDICAL CENTER PKWY STE 220
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2594
Practice Address - Country:US
Practice Address - Phone:615-217-0259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA127885225100000X
TN16486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist