Provider Demographics
NPI:1972660660
Name:AUSTRALUS PHYSIOTHERAPY LLC
Entity Type:Organization
Organization Name:AUSTRALUS PHYSIOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:615-329-3779
Mailing Address - Street 1:2210 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2206
Mailing Address - Country:US
Mailing Address - Phone:615-329-3779
Mailing Address - Fax:615-329-3719
Practice Address - Street 1:2210 8TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2206
Practice Address - Country:US
Practice Address - Phone:615-329-3779
Practice Address - Fax:615-329-3719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5317261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370138OtherMEDICARE GROUP PTAN