Organization Name: | 101 PHYSICAL THERAPY, INC |
NPI Number: | 1023042405 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RUSSELL L. ATKINS (PRESIDENT) |
Mailing Address: | 5704 Ooltewah Ringgold Rd Ooltewah |
State: | TN US |
Postal Code: | 373638713 |
Phone Number: | 4232381301 |
Fax Number: | 4232381302 |
NPI Enumeration Date: | 07/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 6211 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |