Organization
PHYSICAL THERAPY OF JACKSON PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER LUY PT, MBA (PRESIDENT)
(731) 664-1172
Entity
Organization
Contact information
Practice address
2782 N HIGHLAND AVE, SUITE A, JACKSON, TN 38305-1798
(731) 664-1172
(731) 664-3139
Mailing address
2782 N HIGHLAND AVE, SUITE A, JACKSON, TN 38305-1798
(731) 664-1172
(731) 664-3139
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
261QP2000X
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3654237
—
TN
Enumeration date
05/28/2006
Last updated
08/22/2020
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