MEDICARE: RESULTS-AST JV, 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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1740910678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESULTS-AST JV, LLC

Provider Business Mailing Address
First Line	:	PO BOX 306393
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37230-6393
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	26448 MAIN ST
Second Line	:
City	:	ARDMORE
State	:	TN
Zip	:	38449-2913
Country	:	US
Telephone Number	:	931-427-6030
Fax Number	:	931-427-6031

Authorized Official
Title or Position	:	CFO
Name	:	THOMAS BRYAN BARGANIER
Credential	:
Telephone Number	:	205-536-7602

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	06/14/2022

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Directions to “RESULTS-AST JV, LLC ” Practice Location

Language	Start Address	Practice Location

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