Organization
TRICARE REHABILITATION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BABLOO CHACKO (ADMINISTRATOR)
(615) 452-9686
Entity
Organization
Contact information
Practice address
258 E MAIN ST, GALLATIN, TN 37066-2961
(615) 452-9686
(615) 452-9652
Mailing address
258 E MAIN ST, GALLATIN, TN 37066-2961
(615) 452-9686
(615) 452-9652
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
446693
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3370144
—
TN
Enumeration date
07/26/2007
Last updated
11/13/2009
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