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General NPI Number Information
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NPI Number | 1871221580
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Entity Type | Organization
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Legal Business Name | 423 PHYSICAL THERAPY AND PERFORMANCE LLC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 107 LA PORTE DR
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City | CHATTANOOGA
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State | TN
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Zip | 37415-1304
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Country | US
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Telephone | 423-762-5970
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Fax |
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Provider Business Mailing Address
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Address Line | 107 LA PORTE DR
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City | CHATTANOOGA
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State | TN
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Zip | 37415-1304
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Country | US
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Telephone | 423-762-5970
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | DR. ROBERT ANDREW GEAN
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Credential | PT, OCS
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Telephone | 423-762-5970
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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 |
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License Number State |
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