Healthcare Provider Details

I. General information

NPI: 1851632178
Provider Name (Legal Business Name): JEFFREY BROOKS ALTIZER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 CHURCH ST STE 102
NASHVILLE TN
37203-2040
US

IV. Provider business mailing address

2021 CHURCH ST STE 102
NASHVILLE TN
37203-2040
US

V. Phone/Fax

Practice location:
  • Phone: 615-284-7555
  • Fax: 615-284-7075
Mailing address:
  • Phone: 615-284-7555
  • Fax: 615-284-7075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT0000008811
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: