Provider Demographics
NPI:1598098600
Name:CARPENTER, BETHANY N (DPT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:N
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BRADFORD BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38563-4618
Mailing Address - Country:US
Mailing Address - Phone:615-683-3010
Mailing Address - Fax:615-683-3016
Practice Address - Street 1:112 BRADFORD BLVD STE 500
Practice Address - Street 2:
Practice Address - City:GORDONSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38563
Practice Address - Country:US
Practice Address - Phone:615-683-3490
Practice Address - Fax:615-683-3495
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT005484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist