Provider Demographics
NPI:1508680703
Name:SUMMERS, ALI LYNN (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:LYNN
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 54TH AVE N APT 439
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1524
Mailing Address - Country:US
Mailing Address - Phone:224-639-7918
Mailing Address - Fax:
Practice Address - Street 1:6117 CENTENNIAL BLVD STE 3
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1359
Practice Address - Country:US
Practice Address - Phone:224-639-7918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist