Healthcare Provider Details

I. General information

NPI: 1477766590
Provider Name (Legal Business Name): SAMUEL HINGHA PIEH II II DPT, MBA, MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 03/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 AIRLINE RD STE 106
ARLINGTON TN
38002-9878
US

IV. Provider business mailing address

9049 SUTTERS MILL CV W
CORDOVA TN
38016-9523
US

V. Phone/Fax

Practice location:
  • Phone: 901-867-8989
  • Fax: 901-867-8757
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0000007034
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: