Provider Demographics
NPI:1124847678
Name:OPTIMUM PHYSICAL THERAPY
Entity type:Organization
Organization Name:OPTIMUM PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:423-297-1017
Mailing Address - Street 1:1742 SYLVAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-3928
Mailing Address - Country:US
Mailing Address - Phone:423-895-1722
Mailing Address - Fax:
Practice Address - Street 1:206 CHEROKEE PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-2769
Practice Address - Country:US
Practice Address - Phone:423-895-1722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy