Organization
IMPACT PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BOUCHER P.T. (OWNER)
(615) 453-1422
Entity
Organization
Contact information
Practice address
1430 W BADDOUR PKWY, SUITE C, LEBANON, TN 37087-2514
(615) 453-1422
(615) 453-1429
Mailing address
1430 W BADDOUR PKWY STE C, LEBANON, TN 37087-2656
(615) 453-1422
(615) 453-1429
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/17/2008
Last updated
05/12/2023
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