Healthcare Provider Details

I. General information

NPI: 1972544542
Provider Name (Legal Business Name): PHYLLIS F HATFIELD PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 ELM HILL PIKE SUITE 100
NASHVILLE TN
37210-4523
US

IV. Provider business mailing address

1532 FACTORS WALK
MURFREESBORO TN
37128-0702
US

V. Phone/Fax

Practice location:
  • Phone: 615-366-6090
  • Fax: 615-366-6098
Mailing address:
  • Phone: 615-366-6090
  • Fax: 615-366-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6577
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: