Provider Demographics
NPI:1619675733
Name:FLOURISH CONCIERGE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:FLOURISH CONCIERGE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:423-845-5845
Mailing Address - Street 1:3422 STONERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2181
Mailing Address - Country:US
Mailing Address - Phone:423-845-5845
Mailing Address - Fax:
Practice Address - Street 1:3422 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2181
Practice Address - Country:US
Practice Address - Phone:423-845-5845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty