Healthcare Provider Details

I. General information

NPI: 1124847678
Provider Name (Legal Business Name): OPTIMUM PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 CHEROKEE PARK DR STE 2
ELIZABETHTON TN
37643-2769
US

IV. Provider business mailing address

1742 SYLVAN HILL RD
ELIZABETHTON TN
37643-3928
US

V. Phone/Fax

Practice location:
  • Phone: 423-895-1722
  • Fax:
Mailing address:
  • Phone: 423-895-1722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. RACHEL LYNNE PETERS
Title or Position: OWNER, OPERATOR
Credential: PT, DPT
Phone: 423-297-1017