Provider Demographics
NPI:1831109867
Name:PHYSICAL THERAPY SERVICES, P.A.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DHSC, OCS, SCS,
Authorized Official - Phone:423-543-0073
Mailing Address - Street 1:1975 W ELK AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-3787
Mailing Address - Country:US
Mailing Address - Phone:423-543-0073
Mailing Address - Fax:423-543-1277
Practice Address - Street 1:1975 W ELK AVE STE 1
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-3787
Practice Address - Country:US
Practice Address - Phone:423-543-0073
Practice Address - Fax:423-543-1277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4088991Medicaid
TN0446517Medicaid
TN0446517Medicaid