| NPI | 1114340072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA WHITSELL Provider Enrollment Manager 615-465-2877 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: PA PT005383L) |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2017-12-14 |