Organization
RESILIENT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK A LEIST D.C. (OFFICE MANAGER)
(615) 636-5923
Entity
Organization
Contact information
Practice address
204 WARD CIR, STE 300, BRENTWOOD, TN 37027-7551
(615) 636-5923
(615) 915-3187
Mailing address
204 WARD CIR, STE 300, BRENTWOOD, TN 37027-7551
(615) 636-5923
(615) 915-3187
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
2649
TN
225100000X
Physical Therapist
10999
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10999
STATE LICENSE #
TN
01
—
2134
STATE LICENSE #
TN
01
—
2649
STATE LICENSE #
TN
Enumeration date
08/13/2015
Last updated
01/22/2017
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