Healthcare Provider Details

I. General information

NPI: 1669704383
Provider Name (Legal Business Name): NUTHERA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 AIRLINE RD STE 106
ARLINGTON TN
38002-4894
US

IV. Provider business mailing address

6050 AIRLINE RD STE 106
ARLINGTON TN
38002-4894
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number7034
License Number StateTN

VIII. Authorized Official

Name: DR. SAMUEL H PIEH II
Title or Position: PRESIDENT
Credential: D.P.T, M.P.T, M.B.A
Phone: 901-867-8989