Provider Demographics
NPI:1164549374
Name:PHYSIOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP SENIOR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAASCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-963-8723
Mailing Address - Street 1:739 PRESIDENT PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6844
Mailing Address - Country:US
Mailing Address - Phone:615-355-5640
Mailing Address - Fax:615-355-5650
Practice Address - Street 1:739 PRESIDENT PL
Practice Address - Street 2:SUITE 200
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6844
Practice Address - Country:US
Practice Address - Phone:615-355-5640
Practice Address - Fax:615-355-5650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4098378OtherBCBS
TN446536Medicare ID - Type Unspecified