Provider Demographics
NPI:1316257413
Name:BACHMAN, SAMUEL ROBERT
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:ROBERT
Last Name:BACHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 HAMILL RD
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5179
Mailing Address - Country:US
Mailing Address - Phone:423-842-9322
Mailing Address - Fax:866-591-0619
Practice Address - Street 1:1790 HAMILL RD
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-5179
Practice Address - Country:US
Practice Address - Phone:423-842-9322
Practice Address - Fax:866-591-0619
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist