Antonio Guisadio, PT

Individual provider Active NPI Physical Therapist · Jefferson Cty, TN

NPI 1144848573 · NPPES record last updated Jul 13, 2020

Key facts

NPI
1144848573
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
3127 (TN)
Practice address
1123 N Chucky Pike
Jefferson Cty, TN 37760-4851
Phone
(865) 475-6930
NPI assigned
Jul 13, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3127TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Morristown-Hamblen Homecare and Hospice, LLC Past
since Jul 19, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 3127 TN Yes

Addresses

Primary practice location

1123 N Chucky Pike
Jefferson Cty, TN 37760-4851

Mailing address

2021 N Sizer Ave Apt 255
Jefferson Cty, TN 37760-5142
Phone (865) 454-5440

Other providers in Jefferson Cty, TN

All providers in Jefferson Cty, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.