MEDICARE: MARILOU HAREN PT

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
1	225100000X	Physical Therapist	13635	TN
2	225100000X	Physical Therapist	017471	PA
3	225100000X	Physical Therapist	PT7274	MS

General Provider Information

NPI Number	:	1881642411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILOU HAREN PT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	5226 AIRLINE RD STE 131
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-9939
Country	:	US
Telephone Number	:	901-441-7997
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/07/2025

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