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

Individual provider Physical Therapist · NPI 1790304301

Petra Godefrieda Mysiewicz, PT is a Physical Therapist in Jackson, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2020
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1535 Vann Dr
Jackson, TN 38305-2095
Phone: (731) 984-9962
Fax: (731) 984-9941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2244 (TN)

Record details

NPI number1790304301
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedApril 14, 2020
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020

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