Provider Demographics
NPI:1609891589
Name:CORE SOLUTIONS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:CORE SOLUTIONS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:ODOM
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MOMT
Authorized Official - Phone:615-292-0199
Mailing Address - Street 1:PO BOX 40525
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-0525
Mailing Address - Country:US
Mailing Address - Phone:615-292-0199
Mailing Address - Fax:615-292-0357
Practice Address - Street 1:2300 21ST AVE S
Practice Address - Street 2:SUITE 303
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4968
Practice Address - Country:US
Practice Address - Phone:615-292-0199
Practice Address - Fax:615-292-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4126434OtherBCBS GROUP #
TN3734573Medicare UPIN