Provider Demographics
NPI:1629098074
Name:COLBERT, JOSHUA KESLEY (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:KESLEY
Last Name:COLBERT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 BAKERS BRIDGE AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1725
Mailing Address - Country:US
Mailing Address - Phone:615-519-9934
Mailing Address - Fax:
Practice Address - Street 1:615 BAKERS BRIDGE AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1725
Practice Address - Country:US
Practice Address - Phone:615-519-9934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN01306028Medicaid
TN01306028Medicaid