Healthcare Provider Details

I. General information

NPI: 1396704094
Provider Name (Legal Business Name): STAR PHYSICAL THERAPY LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 03/09/2011
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

Practice location:
  • Phone: 615-831-1710
  • Fax: 615-831-1968
Mailing address:
  • Phone: 866-800-9147
  • Fax: 615-591-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: HAL HENNINGER
Title or Position: PARTNER
Credential: PT
Phone: 866-800-9147