Organization
STATE OF TENNESSEE
Active
Other names
Tennessee Department of Intellectual and Developmental Disabilities
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LANCE DEREK IVERSON (DEPUTY COMMISSIONER)
(615) 253-6710
Entity
Organization
Contact information
Practice address
11437 MILTON WILSON RD, DIDD WEST TN SEATING AND POSITIONING CLINIC, ARLINGTON, TN 38002-4926
(901) 745-7509
Mailing address
400 DEADERICK ST, CITIZENS PLAZA, 10TH FLOOR, NASHVILLE, TN 37243-0001
(615) 253-6710
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q017827
—
TN
Enumeration date
06/02/2014
Last updated
06/29/2016
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