Provider Demographics
NPI: | 1447741715 |
---|---|
Name: | ABSOLUTE TREATMENT, LLC |
Entity type: | Organization |
Organization Name: | ABSOLUTE TREATMENT, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ZACHARY |
Authorized Official - Middle Name: | CARSON |
Authorized Official - Last Name: | LYNCH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PT, DPT, CSCS |
Authorized Official - Phone: | 423-273-3428 |
Mailing Address - Street 1: | 920 PARKSIDE AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | MORRISTOWN |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37814-1775 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 423-273-3428 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2813 W ANDREW JOHNSON HWY # 3 |
Practice Address - Street 2: | |
Practice Address - City: | MORRISTOWN |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37814-3216 |
Practice Address - Country: | US |
Practice Address - Phone: | 423-273-3428 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-05-22 |
Last Update Date: | 2018-05-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TN | 11172 | 261QP2000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |