Provider Demographics
NPI:1386914158
Name:ACHIEVE HEALTH AND WELLNESS
Entity type:Organization
Organization Name:ACHIEVE HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-477-1101
Mailing Address - Street 1:406 ROY MARTIN RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-2244
Mailing Address - Country:US
Mailing Address - Phone:423-477-1101
Mailing Address - Fax:423-477-1102
Practice Address - Street 1:406 ROY MARTIN RD
Practice Address - Street 2:SUITE 9
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-2244
Practice Address - Country:US
Practice Address - Phone:423-477-1101
Practice Address - Fax:423-477-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G656330Medicare PIN