Provider Demographics
NPI:1063605491
Name:FRANKLIN REHAB CLINIC
Entity type:Organization
Organization Name:FRANKLIN REHAB CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-952-3050
Mailing Address - Street 1:2511 WESLEY ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1723
Mailing Address - Country:US
Mailing Address - Phone:423-952-3050
Mailing Address - Fax:
Practice Address - Street 1:2511 WESLEY ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1723
Practice Address - Country:US
Practice Address - Phone:423-952-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19387208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3702471Medicare PIN