Provider Demographics
NPI:1639728793
Name:FOUNDATION PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:FOUNDATION PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSPT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:423-531-4444
Mailing Address - Street 1:5604 OLD HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-8815
Mailing Address - Country:US
Mailing Address - Phone:423-531-4444
Mailing Address - Fax:423-531-4445
Practice Address - Street 1:5604 OLD HUNTER RD
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-8815
Practice Address - Country:US
Practice Address - Phone:423-531-4444
Practice Address - Fax:423-531-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty