Provider Demographics
NPI:1447331962
Name:REHAB GROUP OF MORRISTOWN, INC.
Entity type:Organization
Organization Name:REHAB GROUP OF MORRISTOWN, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:865-828-3638
Mailing Address - Street 1:8731 RUTLEDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37861
Mailing Address - Country:US
Mailing Address - Phone:865-828-3638
Mailing Address - Fax:865-828-6332
Practice Address - Street 1:8731 RUTLEDGE PIKE
Practice Address - Street 2:REHAB GROUP OF RUTLEGE
Practice Address - City:RUTLEDGE
Practice Address - State:TN
Practice Address - Zip Code:37861
Practice Address - Country:US
Practice Address - Phone:865-828-3638
Practice Address - Fax:865-828-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000004729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3653605Medicare ID - Type Unspecified