Provider Demographics
NPI:1396817383
Name:PHYSICAL THERAPY ASSOCIATES OF CHATTANOOGA, INC
Entity type:Organization
Organization Name:PHYSICAL THERAPY ASSOCIATES OF CHATTANOOGA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:THAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-870-6004
Mailing Address - Street 1:2158 NORTHGATE PARK LANE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-6958
Mailing Address - Country:US
Mailing Address - Phone:423-870-6004
Mailing Address - Fax:423-870-6005
Practice Address - Street 1:2158 NORTHGATE PARK LANE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-6958
Practice Address - Country:US
Practice Address - Phone:423-870-6004
Practice Address - Fax:423-870-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446558OtherRIVERBEND GOVERNMENT
TN4978909OtherCIGNA
TN165334501OtherACS DEPARTMENT OF LABOR
TN3110918OtherBLUECROSS BLUESHIELD TN
TN64-50537OtherMEDICA
TN650009038OtherPALMETTO RAILROAD M'CARE
TN94573OtherUNITED HEALTHCARE
TN3110918OtherBCBS/TN
TN94573OtherUNITED HEALTHCARE