Provider Demographics
NPI:1497850804
Name:VOLUNTEER HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:VOLUNTEER HEALTHCARE SERVICES, INC.
Other - Org Name:DYNAMIC PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:BAHIA
Authorized Official - Last Name:LOTIVIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:423-586-9495
Mailing Address - Street 1:6111 W ANDREW JOHNSON HWY STE 5
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8585
Mailing Address - Country:US
Mailing Address - Phone:423-586-9495
Mailing Address - Fax:423-586-9549
Practice Address - Street 1:6111 W ANDREW JOHNSON HWY STE 5
Practice Address - Street 2:
Practice Address - City:TALBOTT
Practice Address - State:TN
Practice Address - Zip Code:37877-8585
Practice Address - Country:US
Practice Address - Phone:423-586-9495
Practice Address - Fax:423-586-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN446679261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN300150187Medicaid