Individual
ADAM BROOKS RISINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3964 GOODMAN RD E, SUITE 111, SOUTHAVEN, MS 38672-8761
(662) 890-6953
(662) 890-6954
Mailing address
2001 MALLORY LN, SUITE 201, FRANKLIN, TN 37067-8233
(615) 373-9461
(615) 221-9054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5427
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0723280001
PALMETTO
TN
01
—
4041683
BCBS
TN
01
—
620819926
BCBS
MS
01
—
620819926
AETNA
TN
01
—
P00266256
RAILROAD MEDICARE
TN
Enumeration date
05/24/2005
Last updated
10/22/2014
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