Provider Demographics
NPI:1326385444
Name:THE THERAPY CENTER OF HENDERSONVILLE
Entity Type:Organization
Organization Name:THE THERAPY CENTER OF HENDERSONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:BRANTLEY
Authorized Official - Last Name:SOUTHARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:615-826-7113
Mailing Address - Street 1:139 MAPLE ROW BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4487
Mailing Address - Country:US
Mailing Address - Phone:615-826-7113
Mailing Address - Fax:615-826-7139
Practice Address - Street 1:139 MAPLE ROW BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4487
Practice Address - Country:US
Practice Address - Phone:615-826-7113
Practice Address - Fax:615-826-7139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty