Provider Demographics
NPI:1649815150
Name:INFINITE REHAB AND WELLNESS LLC
Entity type:Organization
Organization Name:INFINITE REHAB AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT GCS
Authorized Official - Phone:731-618-1803
Mailing Address - Street 1:189 W UNIVERSITY PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:731-240-0059
Practice Address - Street 1:189 W UNIVERSITY PKWY STE B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1671
Practice Address - Country:US
Practice Address - Phone:731-300-1080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy