Provider Demographics
NPI:1740427723
Name:OUTPATIENT REHAB AND THERAPY CENTER OF TN INC.
Entity Type:Organization
Organization Name:OUTPATIENT REHAB AND THERAPY CENTER OF TN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:901-314-5106
Mailing Address - Street 1:8122 CALE FALLS LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8947
Mailing Address - Country:US
Mailing Address - Phone:901-314-5106
Mailing Address - Fax:
Practice Address - Street 1:8122 CALE FALLS LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-8947
Practice Address - Country:US
Practice Address - Phone:901-314-5106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42542278P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary RehabilitationGroup - Multi-Specialty