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General NPI Number Information
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NPI Number | 1538839667
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Entity Type | Organization
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Legal Business Name | DR. JEN LE COGUIC, LLC
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 2933 BERRY HILL DR UNIT A
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City | NASHVILLE
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State | TN
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Zip | 37204-3126
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Country | US
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Telephone | 615-498-0410
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Fax |
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Provider Business Mailing Address
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Address Line | 262 SUNRISE AVE
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City | NASHVILLE
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State | TN
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Zip | 37211-2904
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Country | US
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Telephone | 615-498-0410
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER LE COGUIC
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Credential | PT, DPT, OCS
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Telephone | 615-498-0410
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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 |
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License Number State |
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