Healthcare Provider Details

I. General information

NPI: 1891285185
Provider Name (Legal Business Name): TN THERAPY OUTSOURCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2018
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 UNION UNIVERSITY DR STE G
JACKSON TN
38305-3714
US

IV. Provider business mailing address

1296 UNION UNIVERSITY DR STE G
JACKSON TN
38305-3714
US

V. Phone/Fax

Practice location:
  • Phone: 731-882-7783
  • Fax: 800-559-7091
Mailing address:
  • Phone: 731-882-7783
  • Fax: 800-559-7091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8904
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL CHUA
Title or Position: CHIEF INSPIRATION OFFICER
Credential: PT, DPT
Phone: 865-406-7675