Organization
SHINE PEDIATRIC THERAPY
Active
Other names
Springfield Pediatric Therapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE THOMPSON (BILLING/CREDENTIALING MANAGER)
(615) 476-9730
Entity
Organization
Contact information
Practice address
514 S BROWN ST, SUITE 600, SPRINGFIELD, TN 37172-2937
(615) 382-0500
(615) 382-0501
Mailing address
PO BOX 1637, SPRINGFIELD, TN 37172-1637
(615) 382-0500
(615) 382-0501
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3432
TN
Other
Enumeration date
07/24/2012
Last updated
09/02/2019
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