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Southern Physical Therapy, LLC

Physical Therapist in Columbia, TN. Organization (NPI-2).

NPI number1720162662
StatusActive
Last updated in NPPESFeb 23, 2015

Details

NPI
1720162662
Entity type
Organization (NPI-2)
Legal business name
Southern Physical Therapy, LLC
Organization subpart
No
Enumeration date
Oct 25, 2006
Last updated
Feb 23, 2015

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical TherapistPT2044TNYes
225100000X Physical TherapistPT6832TN

Practice location

1810 Shady Brook St
Suite 3
Columbia, TN 38401-3993

Phone 931-388-8500

Mailing address

1810 Shady Brook St
Suite 3
Columbia, TN 38401-3993

Phone 931-388-8500

Authorized official

William John Mastalerz
Owner/Administrator
9313888500

Is something wrong?

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Other Physical Therapist providers in Columbia, TN

All 69 Physical Therapist providers in Columbia · All 1,681 providers in Columbia

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