Provider Demographics
NPI:1770755837
Name:TUESCA, BRIAN (PT)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:TUESCA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 DERBY CT
Mailing Address - Street 2:
Mailing Address - City:JOELTON
Mailing Address - State:TN
Mailing Address - Zip Code:37080-9439
Mailing Address - Country:US
Mailing Address - Phone:615-855-7946
Mailing Address - Fax:
Practice Address - Street 1:101 MOORELAND DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-3974
Practice Address - Country:US
Practice Address - Phone:615-384-0687
Practice Address - Fax:615-384-3944
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-29
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5265OtherSTATE OF TENNESSEE