Healthcare Provider Details
I. General information
NPI: 1659639052
Provider Name (Legal Business Name): PHYSICAL THERAPY SPECIALISTS OF TENNESSEE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2012
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3326 ASPEN GROVE DR STE 306
FRANKLIN TN
37067-4857
US
IV. Provider business mailing address
412 AUTUMN LAKE TRL
FRANKLIN TN
37067-2693
US
V. Phone/Fax
- Phone: 615-305-8896
- Fax: 615-807-2684
- Phone: 615-305-8896
- Fax: 615-807-2684
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251S0007X |
| Taxonomy | Sports Physical Therapist |
| License Number | 6200 |
| License Number State | TN |
VIII. Authorized Official
Name:
MELISSA
HARRIS
EISENHAUER
Title or Position: OWNER, PHYSICAL THERAPIST
Credential: PT
Phone: 615-305-8896