Healthcare Provider Details

I. General information

NPI: 1245743178
Provider Name (Legal Business Name): APPLE PHYSICAL MEDICINE AND REHABILITATION, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7446 SHALLOWFORD RD STE 108
CHATTANOOGA TN
37421-2352
US

IV. Provider business mailing address

7446 SHALLOWFORD RD STE 108
CHATTANOOGA TN
37421-2352
US

V. Phone/Fax

Practice location:
  • Phone: 423-855-7376
  • Fax: 423-855-8455
Mailing address:
  • Phone: 423-855-7376
  • Fax: 423-855-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS CIRCOLONE
Title or Position: OWNER
Credential: DC
Phone: 423-855-7376