MEDICARE: PHYSICAL THERAPY ASSOCIATES OF CHATTANOOGA, INC

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
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	446558	OTHER	TN	RIVERBEND GOVERNMENT
2	4978909	OTHER	TN	CIGNA
3	165334501	OTHER	TN	ACS DEPARTMENT OF LABOR
4	3110918	OTHER	TN	BLUECROSS BLUESHIELD TN
5	64-50537	OTHER	TN	MEDICA
6	650009038	OTHER	TN	PALMETTO RAILROAD M'CARE
7	94573	OTHER	TN	UNITED HEALTHCARE
8	3110918	OTHER	TN	BCBS/TN

General Provider Information

NPI Number	:	1396817383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY ASSOCIATES OF CHATTANOOGA, INC

Provider Business Mailing Address
First Line	:	2158 NORTHGATE PARK LANE
Second Line	:	SUITE 102
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-6958
Country	:	US
Telephone Number	:	423-870-6004
Fax Number	:	423-870-6005

Provider Business Practice Location Address
First Line	:	2158 NORTHGATE PARK LANE
Second Line	:	SUITE 102
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-6958
Country	:	US
Telephone Number	:	423-870-6004
Fax Number	:	423-870-6005

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. CATHERINE L THAXTON
Credential	:
Telephone Number	:	423-870-6004

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	06/21/2018

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