MEDICARE: BODIES IN BALANCE PHYSICAL THERAPY, PLLC

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	NONE FOR GROUP	TN

General Provider Information

NPI Number	:	1922126408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODIES IN BALANCE PHYSICAL THERAPY, PLLC

Provider Business Mailing Address
First Line	:	516 TREMONT ST.
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405
Country	:	US
Telephone Number	:	423-756-4781
Fax Number	:	423-756-4782

Provider Business Practice Location Address
First Line	:	516 TREMONT ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-4153
Country	:	US
Telephone Number	:	423-756-4781
Fax Number	:	423-756-4782

Authorized Official
Title or Position	:	PRESIDENT AND OWNER OPERATOR
Name	:	LISA M FOX
Credential	:	PT
Telephone Number	:	423-756-4781

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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