Provider Demographics
NPI:1508983883
Name:GILREATH, RODGER D II (PT, DPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:RODGER
Middle Name:D
Last Name:GILREATH
Suffix:II
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2862 TRELAWNY DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4036
Mailing Address - Country:US
Mailing Address - Phone:402-212-5573
Mailing Address - Fax:
Practice Address - Street 1:2200 21ST AVE S STE 304
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4929
Practice Address - Country:US
Practice Address - Phone:615-292-4960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist