Organization
BENTON COUNTY PHYSICAL THERAPY
Active
Other names
Dover Rehabilitation Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA JEAN PINION (CORPORATE SECRETARY/OFFICE MANAGER)
(931) 232-0057
Entity
Organization
Contact information
Practice address
543 HIGHWAY 79, DOVER, TN 37058-5966
(931) 232-0057
(931) 232-0067
Mailing address
P.O. BOX 465, PARIS, TN 38242
(931) 232-0057
(931) 232-0067
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000002294
TN
261QP2000X
Physical Therapy Clinic/Center
PT2294
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044-6602
—
TN
05
—
0446602
—
TN
01
—
3106297
BLUE CROSS BLUE SHIELD
TN
Enumeration date
01/05/2006
Last updated
12/02/2014
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