Organization · NPI-2

101 Physical Therapy, INC

Clinic/Center, Physical Therapy · Ooltewah, TN

NPI number1023042405
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1023042405
Entity type
Organization (NPI-2)
Legal business name
101 Physical Therapy, INC
Organization subpart
No
Enumeration date
Jul 10, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP2000X Clinic/Center, Physical Therapy6211TNYes

Practice location

5704 Ooltewah Ringgold Rd
Ooltewah, TN 37363-8713

Phone 423-238-1301 · Fax 423-238-1302

Mailing address

5704 Ooltewah Ringgold Rd
Ooltewah, TN 37363-8713

Phone 423-238-1301 · Fax 423-238-1302

Authorized official

Russell L. Atkins
President
4232381301

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