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NPI Code Detail

MEDICARE: SPT

MEDICARE: SPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant3348TN

General Provider Information

NPI Number : 1184763914
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPT
Provider Business Mailing Address
First Line : 472 BETHANY CIR
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-4126
Country : US
Telephone Number : 615-867-3218
Fax Number :
Provider Business Practice Location Address
First Line : 206 BEDFORD WAY
Second Line :
City : FRANKLIN
State : TN
Zip : 37064-5526
Country : US
Telephone Number : 615-831-1710
Fax Number :
Authorized Official
Title or Position : CREDENTIALING INSURANCE COORDINATOR
Name : DONNA DILWORTH
Credential :
Telephone Number : 615-591-6590
Provider Enumeration Date : 02/06/2007
Last Update Date : 04/07/2008

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Directions to “SPT ” Practice Location

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