Provider Demographics
NPI:1245743178
Name:APPLE PHYSICAL MEDICINE AND REHABILITATION, PC
Entity Type:Organization
Organization Name:APPLE PHYSICAL MEDICINE AND REHABILITATION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRCOLONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-855-7376
Mailing Address - Street 1:7446 SHALLOWFORD RD STE 108
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2352
Mailing Address - Country:US
Mailing Address - Phone:423-855-7376
Mailing Address - Fax:423-855-8455
Practice Address - Street 1:7446 SHALLOWFORD RD STE 108
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2352
Practice Address - Country:US
Practice Address - Phone:423-855-7376
Practice Address - Fax:423-855-8455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation