Provider Demographics
NPI:1992985980
Name:RHODES, MICHAEL K (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:K
Last Name:RHODES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681478
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1478
Mailing Address - Country:US
Mailing Address - Phone:615-591-6590
Mailing Address - Fax:615-591-6601
Practice Address - Street 1:232 HUTTON PL
Practice Address - Street 2:SUITE 120
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-4932
Practice Address - Country:US
Practice Address - Phone:615-792-5733
Practice Address - Fax:615-792-5734
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446631Medicaid
TN0446631Medicaid