MEDICARE: AFFINITY 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
1	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1669294195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY THERAPY LLC

Provider Business Mailing Address
First Line	:	2443 HIGHWAY 41 S UNIT 104
Second Line	:
City	:	GREENBRIER
State	:	TN
Zip	:	37073-4540
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 S BROADWAY ST # 1011
Second Line	:
City	:	PORTLAND
State	:	TN
Zip	:	37148-1628
Country	:	US
Telephone Number	:	615-953-0390
Fax Number	:

Authorized Official
Title or Position	:	SLP
Name	:	MARINA COAKLEY
Credential	:
Telephone Number	:	615-953-0390

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	01/05/2025

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Directions to “AFFINITY THERAPY LLC ” Practice Location

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