Basic Information
Provider Information
NPI: 1205165693
EntityType: 2
ReplacementNPI:  
OrganizationName: WOODS PHYSICAL THERAPY LLC
LastName:  
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Mailing Information
Address1: 8823 PRODUCTION LN
Address2:  
City: OOLTEWAH
State: TN
PostalCode: 373636511
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 4232383473
Practice Location
Address1: 925 S CHURCH ST STE C200
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371304994
CountryCode: US
TelephoneNumber: 6152254500
FaxNumber: 6152254505
Other Information
ProviderEnumerationDate: 12/14/2009
LastUpdateDate: 12/14/2009
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: BAGE
AuthorizedOfficialFirstName: TROY
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AuthorizedOfficialTitleorPosition: PRESEDENT
AuthorizedOfficialTelephone: 4232387217
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM1300X  N Ambulatory Health Care FacilitiesClinic/CenterMulti-Specialty
261QR0400X  N Ambulatory Health Care FacilitiesClinic/CenterRehabilitation
261QP2000X  Y Ambulatory Health Care FacilitiesClinic/CenterPhysical Therapy

No ID Information.


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