Provider Demographics
NPI:1871785576
Name:KERRY BECHT PHYSICAL THERAPY AND MASSAGE, INC.
Entity type:Organization
Organization Name:KERRY BECHT PHYSICAL THERAPY AND MASSAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BECHT
Authorized Official - Suffix:
Authorized Official - Credentials:PT, LMT
Authorized Official - Phone:615-444-1408
Mailing Address - Street 1:1427 W BADDOUR PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3062
Mailing Address - Country:US
Mailing Address - Phone:615-444-1408
Mailing Address - Fax:615-444-1393
Practice Address - Street 1:1427 W BADDOUR PKWY STE A
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087
Practice Address - Country:US
Practice Address - Phone:615-444-1408
Practice Address - Fax:615-444-1393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN36530542Medicare PIN