Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gavin Blackwell

Individual provider Physical Therapy Assistant · NPI 1154863454

Gavin Blackwell is a Physical Therapy Assistant in Jackson, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2016

Practice location Address checks out

115 Quail Rdg
Jackson, TN 38305-5420
Phone: (731) 803-0654
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 0000006264 (TN)

Record details

NPI number1154863454
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 17, 2016
Last updated in NPPESNovember 17, 2016
Mailing address115 Quail Rdg, Jackson, TN 38305-5420

Other providers in Jackson