Provider Demographics
NPI:1720458557
Name:FULL CIRCLE THERAPY, PLLC
Entity type:Organization
Organization Name:FULL CIRCLE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:615-545-4271
Mailing Address - Street 1:215 WELLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5739
Mailing Address - Country:US
Mailing Address - Phone:615-545-4271
Mailing Address - Fax:888-441-5621
Practice Address - Street 1:215 WELLINGTON WAY
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5739
Practice Address - Country:US
Practice Address - Phone:615-545-4271
Practice Address - Fax:888-441-5621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6498261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy