Provider Demographics
NPI:1164590311
Name:TENNESSEE THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:TENNESSEE THERAPY SERVICES, LLC
Other - Org Name:ARDMORE/PULASKI PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:931-424-5588
Mailing Address - Street 1:203 VILLAGE SQ
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-2929
Mailing Address - Country:US
Mailing Address - Phone:931-424-5588
Mailing Address - Fax:931-424-5590
Practice Address - Street 1:203 VILLAGE SQ
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-2929
Practice Address - Country:US
Practice Address - Phone:931-424-5588
Practice Address - Fax:931-424-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-05-15
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
TN4033548OtherBLUE CROSS NUMBER
TN3151382OtherGROUP BLUE CROSS NUMBER
TN3655850OtherPTAN
TN4069718OtherPTAN
TN3655557Medicare PIN
TN4069718OtherPTAN
TN3652679Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER