Provider Demographics
NPI:1083652184
Name:PHYSIOTHERAPY ASSOCIATES INC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES INC
Other - Org Name:PHYSIOTHERAPY ASSOCIATES-CROSSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT AND SECREATARY
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-1100
Mailing Address - Street 1:4714 GETTYSBURG RD
Mailing Address - Street 2:LEGAL DEPARTMENT
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4325
Mailing Address - Country:US
Mailing Address - Phone:717-972-1100
Mailing Address - Fax:
Practice Address - Street 1:118 BROWN AVE STE 104
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-7740
Practice Address - Country:US
Practice Address - Phone:931-456-6608
Practice Address - Fax:931-456-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446557Medicaid
TN4093294OtherBLUECROSS/BLUESHIELD/TN
TN5186150OtherAETNA
TN0626451OtherCIGNA
TN644001OtherUNITED HEALTHCARE
TN4093294OtherBLUECROSS/BLUESHIELD/TN
TN0446557Medicaid