Healthcare Provider Details

I. General information

NPI: 1528718384
Provider Name (Legal Business Name): ANDREA GOLDMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 ELMINGTON AVE
NASHVILLE TN
37205-2508
US

IV. Provider business mailing address

710 CLEO MILLER DR APT 224
NASHVILLE TN
37206-2569
US

V. Phone/Fax

Practice location:
  • Phone: 865-805-0994
  • Fax:
Mailing address:
  • Phone: 865-805-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT018868
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT0000013938
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: