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NPI Code Detail

MEDICARE: PITTMAN PHYSICAL THERAPY LLC

MEDICARE: PITTMAN 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
1261QP2000XPhysical Therapy Clinic/Center5704TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13736856OTHERTNMEDICARE GROUP NUMBER
4DG5965OTHERTNRAILROAD MEDICARE PROVIDER NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
24143885OTHERTNBLUE CROSS BLUE SHIELD OF TN GROUP PROVIDER NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790987592
Entity Type Code : Organization
Provider Name (Legal Business Name) : PITTMAN PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 632 W POPLAR AVE
Second Line :
City : COLLIERVILLE
State : TN
Zip : 38017-2540
Country : US
Telephone Number : 901-850-5246
Fax Number : 901-850-5226
Provider Business Practice Location Address
First Line : 632 W POPLAR AVE
Second Line :
City : COLLIERVILLE
State : TN
Zip : 38017-2540
Country : US
Telephone Number : 901-850-5246
Fax Number : 901-850-5226
Authorized Official
Title or Position : PRESIDENT
Name : JEREMY H PITTMAN
Credential :
Telephone Number : 901-850-5246
Provider Enumeration Date : 06/04/2007
Last Update Date : 03/11/2024

Similar Medicare Providers

1235067083 — ANNA HICKS DPT
Practice Location Address:
632 W POPLAR AVE
COLLIERVILLE, TN
38017-2540
Practice Phone: 901-850-5246
Practice Fax:
1578529293 — ANNA LOREN POSSEMATO PT, DPT
Practice Location Address:
632 W POPLAR AVE
COLLIERVILLE, TN
38017-2540
Practice Phone: 901-850-5246
Practice Fax:
1285703884 — CHARLES E. YOUNG, JR, DDS
Practice Location Address:
624 W POPLAR AVE
COLLIERVILLE, TN
38017-2540
Practice Phone: 901-853-2520
Practice Fax: 901-854-9273
1528137171 — CHARLES EDMUND YOUNG JR. D.D.S.
Practice Location Address:
624 W POPLAR AVE
COLLIERVILLE, TN
38017-2540
Practice Phone: 901-853-2520
Practice Fax: 901-854-9273
1790855989 — DIANA YUAN LIN D.D.S.
Practice Location Address:
624 W POPLAR AVE
COLLIERVILLE, TN
38017-2540
Practice Phone: 901-853-2520
Practice Fax: 901-854-9273
1811652241 — CARLY ARCHER NP
Practice Location Address:
604 W POPLAR AVE
COLLIERVILLE, TN
38017-2540
Practice Phone: 901-457-0541
Practice Fax: 901-457-0542

Directions to “PITTMAN PHYSICAL THERAPY LLC ” Practice Location

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