Healthcare Provider Details

I. General information

NPI: 1326951534
Provider Name (Legal Business Name): ACTIVE AND MOBILE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7135 DODSON BRANCH RD
COOKEVILLE TN
38501-9315
US

IV. Provider business mailing address

7135 DODSON BRANCH RD
COOKEVILLE TN
38501-9315
US

V. Phone/Fax

Practice location:
  • Phone: 931-787-4458
  • Fax:
Mailing address:
  • Phone: 931-787-4458
  • Fax:

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: AUSTYN EVERETT
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 931-787-4458