Healthcare Provider Details

I. General information

NPI: 1801524889
Provider Name (Legal Business Name): EVAN SEXTON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 MEMORY LN STE 103
GALLATIN TN
37066-7162
US

IV. Provider business mailing address

PO BOX 681478
FRANKLIN TN
37068-1478
US

V. Phone/Fax

Practice location:
  • Phone: 615-451-5158
  • Fax: 615-451-4033
Mailing address:
  • Phone: 615-591-6590
  • Fax: 615-591-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14329
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: