Basic Information
Provider Information
NPI: 1053364893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIEFLE
FirstName: JENNIFER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 681478
Address2:  
City: FRANKLIN
State: TN
PostalCode: 370681478
CountryCode: US
TelephoneNumber: 8668009147
FaxNumber: 6155916601
Practice Location
Address1: 2410 PATTERSON STREET
Address2: 500
City: NASHVILLE
State: TN
PostalCode: 37203
CountryCode: US
TelephoneNumber: 6155151171
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X7349TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home