| Clarksville Physical Medicine Pllc | |
|
1636 Madison St Clarksville TN 37043-2977 | |
| (931) 801-0550 | |
| Not Available |
| Full Name | Clarksville Physical Medicine Pllc |
|---|---|
| Speciality | Chiropractor |
| Location | 1636 Madison St, Clarksville, Tennessee |
| Authorized Official Name and Position | Kenneth Gilman (ADMINISTRATOR) |
| Authorized Official Contact | 9318010550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksville Physical Medicine Pllc 1636 Madison St Clarksville TN 37043-2977 Ph: (931) 801-0550 | Clarksville Physical Medicine Pllc 1636 Madison St Clarksville TN 37043-2977 Ph: (931) 801-0550 |
| NPI Number | 1598395220 |
|---|---|
| Provider Enumeration Date | 01/22/2020 |
| Last Update Date | 11/07/2024 |
| Medicare PECOS PAC ID | 8729417001 |
|---|---|
| Medicare Enrollment ID | O20200408000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598395220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Kenneth Gilman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093798787 PECOS PAC ID: 0547171597 Enrollment ID: I20120125000470 |
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