Healthcare Provider Details

I. General information

NPI: 1043141591
Provider Name (Legal Business Name): BETHANY NELSON PT DPT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 N HIGHLAND AVE STE B
MURFREESBORO TN
37130-2443
US

IV. Provider business mailing address

1024 N HIGHLAND AVE STE B
MURFREESBORO TN
37130-2443
US

V. Phone/Fax

Practice location:
  • Phone: 678-449-0199
  • Fax: 678-449-0199
Mailing address:
  • Phone: 678-449-0199
  • Fax: 678-449-0199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BETHANY LYNN NELSON
Title or Position: VP OF THERAPY SERVICES
Credential: PT, DPT
Phone: 404-488-5342