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General NPI Number Information
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NPI Number | 1265951503
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Entity Type | Organization
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Legal Business Name | IPA PHYSIO NASHVILLE LLC
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Dates
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Enumeration Date | 09/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 197 THOMPSON LN STE W
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City | NASHVILLE
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State | TN
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Zip | 37211-2415
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Country | US
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Telephone | 615-270-9565
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Fax | 888-508-2057
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Provider Business Mailing Address
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Address Line | 197 THOMPSON LN STE W
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City | NASHVILLE
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State | TN
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Zip | 37211-2415
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Country | US
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Telephone | 615-270-9565
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Fax | 888-508-2057
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Authorized Official
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Title or Position | CEO
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Name | DR. BRADLEY LAWRENCE GROHOVSKY
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Credential | DPT, CFMT
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Telephone | 615-270-9565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT0000010633
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License Number State | TN
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