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NPI Code Detail

MEDICARE: ONMARK PHYSICAL THERAPY, LLC

MEDICARE: ONMARK PHYSICAL THERAPY, LLC
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
1261QM1300XMulti-Specialty Clinic/Center
2261QR0400XRehabilitation Clinic/Center
3261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1932465861
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONMARK PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 8823 PRODUCTION LN
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-6511
Country : US
Telephone Number : 423-238-8923
Fax Number : 423-238-3222
Provider Business Practice Location Address
First Line : 151 NARROWS PKWY STE D
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-8638
Country : US
Telephone Number : 205-981-4534
Fax Number : 205-981-4535
Authorized Official
Title or Position : PAYOR RELATIONS COORDINATOR
Name : KILEY RUSSELL
Credential :
Telephone Number : 423-238-8923
Provider Enumeration Date : 04/04/2012
Last Update Date : 04/05/2012

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Directions to “ONMARK PHYSICAL THERAPY, LLC ” Practice Location

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