Provider Demographics
NPI:1013939149
Name:CLEVELAND PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:CLEVELAND PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:RUMBA
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:423-284-5029
Mailing Address - Street 1:163 MAPLETON FOREST DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-6237
Mailing Address - Country:US
Mailing Address - Phone:423-284-5029
Mailing Address - Fax:423-559-1885
Practice Address - Street 1:163 MAPLETON FOREST DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-6237
Practice Address - Country:US
Practice Address - Phone:423-284-5029
Practice Address - Fax:423-559-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2567261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy