Organization
AQUATHERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY HARDIN (CHIEF MANAGER)
(731) 668-4449
Entity
Organization
Contact information
Practice address
614 CARRIAGE HOUSE DR STE E, JACKSON, TN 38305-4238
(731) 668-4449
Mailing address
614 CARRIAGE HOUSE DR STE E, JACKSON, TN 38305-4238
(731) 668-4449
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446672
—
TN
01
—
161883
BETTER HEALTH PROVIDER #
TN
01
—
27977
UAHC-OMNI PROVIDER #
TN
01
—
332979
TLC PROVIDER #
TN
01
—
4091400
TN CARE SELECT PROVIDER #
TN
01
—
BCBS
4091400
TN
Enumeration date
06/30/2006
Last updated
08/22/2020
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