Provider Demographics
NPI:1356070049
Name:FOOTHILLS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:FOOTHILLS PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DULLING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:865-573-6458
Mailing Address - Street 1:221 W YOUNG HIGH PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-3051
Mailing Address - Country:US
Mailing Address - Phone:865-573-6458
Mailing Address - Fax:865-577-8147
Practice Address - Street 1:221 W YOUNG HIGH PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-3051
Practice Address - Country:US
Practice Address - Phone:865-573-6458
Practice Address - Fax:865-577-8147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty