Provider Demographics
NPI:1609053685
Name:PT PARTNERS, INC
Entity Type:Organization
Organization Name:PT PARTNERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TORRY
Authorized Official - Middle Name:O
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:731-772-5213
Mailing Address - Street 1:144 SOUTH DUPREE ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012-3217
Mailing Address - Country:US
Mailing Address - Phone:731-772-5213
Mailing Address - Fax:
Practice Address - Street 1:144 SOUTH DUPREE ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-3217
Practice Address - Country:US
Practice Address - Phone:731-772-5213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT5643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514682Medicaid
TN1514682Medicaid