Provider Demographics
NPI:1922114529
Name:APPALACHIAN REHABILITATION PROFESSIONALS, PC
Entity Type:Organization
Organization Name:APPALACHIAN REHABILITATION PROFESSIONALS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-392-8104
Mailing Address - Street 1:117 W SEVIER AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3770
Mailing Address - Country:US
Mailing Address - Phone:423-392-8100
Mailing Address - Fax:423-392-8105
Practice Address - Street 1:117 W SEVIER AVE
Practice Address - Street 2:STE 120
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3799
Practice Address - Country:US
Practice Address - Phone:423-392-8100
Practice Address - Fax:423-392-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3701793Medicare PIN