Provider Demographics
NPI:1407388176
Name:FIRST CLASS THERAPY
Entity type:Organization
Organization Name:FIRST CLASS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRIGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-602-8064
Mailing Address - Street 1:114 FACULTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-4257
Mailing Address - Country:US
Mailing Address - Phone:678-602-8064
Mailing Address - Fax:
Practice Address - Street 1:114 FACULTY HILL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TN
Practice Address - Zip Code:37148-4257
Practice Address - Country:US
Practice Address - Phone:678-602-8064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5157405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty