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General NPI Number Information
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NPI Number | 1508869462
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Entity Type | Individual
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Provider Name | ADAM BROOKS RISINGER P.T.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 3964 GOODMAN RD E SUITE 111
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City | SOUTHAVEN
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State | MS
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Zip | 38672-8761
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Country | US
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Telephone | 662-890-6953
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Fax | 662-890-6954
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Provider Business Mailing Address
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Address Line | 2001 MALLORY LN SUITE 201
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City | FRANKLIN
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State | TN
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Zip | 37067-8233
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Country | US
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Telephone | 615-373-9461
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Fax | 615-221-9054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT5427
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License Number State | TN
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