904 Therapy LLC
NPI #1467193102 in Rogersville, Tennessee
Provider Information
- NPI Number
- 1467193102
- Entity Type
- Organization
- Organization Name
- 904 Therapy LLC
- Primary Specialty
- Clinic/Center - Physical Therapy
- Enumeration Date
- Apr 6, 2022
- Last Updated
- Apr 6, 2022
Practice Location
- Address
- 900 W MAIN ST
- City
- Rogersville
- State
- Tennessee
- ZIP Code
- 37857-2448
- Phone
- (423) 500-5600
Authorized Official
- Name
- JORDAN C BLCAK
- Title
- PRESIDENT
- Phone
- (423) 258-2264
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Physical Therapy — Physical Therapy |
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