Provider Demographics
NPI:1902360696
Name:EVOLVE MOVEMENT THERAPY
Entity Type:Organization
Organization Name:EVOLVE MOVEMENT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:615-456-0045
Mailing Address - Street 1:3011 LONGFORD DR STE 7
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-6203
Mailing Address - Country:US
Mailing Address - Phone:615-302-8056
Mailing Address - Fax:615-302-8055
Practice Address - Street 1:7235 HALEY INDUSTRIAL DR FL 2
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9513
Practice Address - Country:US
Practice Address - Phone:615-302-8056
Practice Address - Fax:615-302-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-26
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNPT0000008496OtherBCBS PPO, HUMANA, ETNA, UNHC, CIGNA, TRI-CARE,