Healthcare Provider Details

I. General information

NPI: 1376796342
Provider Name (Legal Business Name): SUMMIT PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 NORTHPOINT BLVD
HIXSON TN
37343-4060
US

IV. Provider business mailing address

4109 MOUNTAIN VIEW AVE STE 100
CHATTANOOGA TN
37415-2096
US

V. Phone/Fax

Practice location:
  • Phone: 423-842-9322
  • Fax: 866-591-0619
Mailing address:
  • Phone: 423-842-9322
  • Fax: 866-591-0619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GEORGIANA CLARY
Title or Position: VICE PRESIDENT OF ADMINISTRATION
Credential:
Phone: 423-842-9322