Healthcare Provider Details
I. General information
NPI: 1124319900
Provider Name (Legal Business Name): TERESA W KEFFER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2011
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5505 EDMONDSON PIKE SUITE 103
NASHVILLE TN
37211-5872
US
IV. Provider business mailing address
PO BOX 681478
FRANKLIN TN
37068-1478
US
V. Phone/Fax
- Phone: 615-831-1710
- Fax: 615-831-1968
- Phone: 615-591-6590
- Fax: 615-591-6601
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 8832 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: