MEDICARE: MRS. MARIA J ADIGUN PT

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	225100000X	Physical Therapist	3850	TN

General Provider Information

NPI Number	:	1841361946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA J ADIGUN PT

Provider Business Mailing Address
First Line	:	2011 HAMILTON BROW PATH
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-2765
Country	:	US
Telephone Number	:	423-313-6765
Fax Number	:	423-531-0600

Provider Business Practice Location Address
First Line	:	2011 HAMILTON BROW PATH
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-2765
Country	:	US
Telephone Number	:	423-313-6765
Fax Number	:	423-531-0600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2006
Last Update Date	:	08/06/2015

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