Healthcare Provider Details

I. General information

NPI: 1376470864
Provider Name (Legal Business Name): THERAFLOW LYMPHEDEMA AND PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3504 CONNELLY LN
CHATTANOOGA TN
37412-1608
US

IV. Provider business mailing address

3504 CONNELLY LN
CHATTANOOGA TN
37412-1608
US

V. Phone/Fax

Practice location:
  • Phone: 706-581-1252
  • Fax:
Mailing address:
  • Phone: 706-581-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOHN WHITTAKER WALLER JR.
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: DPT
Phone: 706-581-1252