Organization
BENTON COUNTY PHYSICAL THERAPY
Active
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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