Provider Demographics
NPI:1275942385
Name:LOOKING AHEAD PEDIATRIC PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:LOOKING AHEAD PEDIATRIC PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:SOBAJIAN
Authorized Official - Last Name:CALLANEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT
Authorized Official - Phone:949-315-0026
Mailing Address - Street 1:316 MATHERSON CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2670
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:570 BAKERS BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6456
Practice Address - Country:US
Practice Address - Phone:615-784-8104
Practice Address - Fax:615-266-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000098002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty