Organization
REHAB SOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES W JONES PT (OWNER PRESEDENT)
(423) 877-4599
Entity
Organization
Contact information
Practice address
6121 SHALLOWFORD RD STE 102, CHATTANOOGA, TN 37421-7810
(423) 877-4599
(423) 877-5611
Mailing address
PO BOX 4147, CHATTANOOGA, TN 37405-0147
(423) 877-4599
(423) 877-5611
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
95
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3106308
BLUE CROSE BLUE SHIELD
TN
Enumeration date
03/15/2007
Last updated
06/09/2025
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