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General NPI Number Information
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NPI Number | 1700030970
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Entity Type | Organization
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Legal Business Name | APEX PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 280 N FAIRMONT AVE
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City | MORRISTOWN
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State | TN
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Zip | 37814-3768
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Country | US
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Telephone | 423-585-5023
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Fax |
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Provider Business Mailing Address
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Address Line | 280 N FAIRMONT AVE
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City | MORRISTOWN
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State | TN
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Zip | 37814-3768
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Country | US
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Telephone | 423-585-5023
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PHYSICAL THERAPIST
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Name | MR. JASON ANDREW WILDER
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Credential | P.T.
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Telephone | 865-809-7842
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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 | 5832
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License Number State | TN
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