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NPI Code Detail

MEDICARE: PHYSIOFIT PHYSICAL THERAPY, LLC

MEDICARE: PHYSIOFIT PHYSICAL THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistLA
2225100000XPhysical TherapistLA

General Provider Information

NPI Number : 1326558917
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSIOFIT PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 6397 LEE HWY STE 300
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-2564
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 2312 DAVID DR STE C
Second Line :
City : METAIRIE
State : LA
Zip : 70003-4504
Country : US
Telephone Number : 504-435-1158
Fax Number : 504-518-4924
Authorized Official
Title or Position : VP REVENUE CYCLE OPERATIONS
Name : KEVIN JOHANNESON
Credential :
Telephone Number : 423-238-7217
Provider Enumeration Date : 10/09/2017
Last Update Date : 04/12/2018

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Directions to “PHYSIOFIT PHYSICAL THERAPY, LLC ” Practice Location

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