Healthcare Provider Details

I. General information

NPI: 1528962529
Provider Name (Legal Business Name): MOTIV PHYSICAL THERAPY AND PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 CHESTNUT ST STE 113
CHATTANOOGA TN
37408-2404
US

IV. Provider business mailing address

2101 CHESTNUT ST STE 113
CHATTANOOGA TN
37408-2404
US

V. Phone/Fax

Practice location:
  • Phone: 423-668-0406
  • Fax: 423-668-0406
Mailing address:
  • Phone: 423-668-0406
  • Fax: 423-668-0406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. WILLIAM STORM WILSON
Title or Position: OWNER
Credential: PT
Phone: 423-668-0406