| Austin Daugherty, | |
|
7016 City Center Way, Fairview, TN 37062-6004 | |
| (615) 799-1915 | |
| (615) 799-5928 |
| Full Name | Austin Daugherty |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 7016 City Center Way, Fairview, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447813969 | NPI | - | NPPES |
| 0446631 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 12304 (Tennessee) | Primary |
| Provider Name | Agilitas Usa, Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1962417444 PECOS PAC ID: 3375454648 Enrollment ID: O20041115000337 |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Daugherty, Po Box 681478, Franklin, TN 37068-1478 Ph: (615) 591-6590 | Austin Daugherty, 7016 City Center Way, Fairview, TN 37062-6004 Ph: (615) 799-1915 |
Caroline Shultz Devault, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1696 Fairview Blvd, Ste.103, Fairview, TN 37062 Phone: 615-799-1915 Fax: 615-799-5928 | |
Nicholas Kramer, Physical Therapist Medicare: Medicare Enrolled Practice Location: 7016 City Center Way, Fairview, TN 37062 Phone: 615-799-1915 Fax: 615-799-5928 | |
Brianna Clark, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7030 City Center Way, Fairview, TN 37062 Phone: 317-544-8926 | |
Zachary Bennett, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7030 City Center Way, Fairview, TN 37062 Phone: 615-799-1915 Fax: 615-799-5928 | |
Linda C Burgess, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7370 Forrest Glenn Rd, Fairview, TN 37062 Phone: 615-400-7370 | |
Jaclynn Whiting, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7030 City Center Way, Fairview, TN 37062 Phone: 615-799-1915 Fax: 615-799-5928 | |
Maritza Garcia-williams, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1696 Fairview Blvd, 103, Fairview, TN 37062 Phone: 615-799-1915 Fax: 615-799-5928 |