Basic Information
Provider Information
NPI: 1053953554
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALMASRI
FirstName: NOUR
MiddleName: WAHIB
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 306393
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372306393
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6153737116
Practice Location
Address1: 780 BRIARCLIFF AVE
Address2:  
City: OAK RIDGE
State: TN
PostalCode: 378308756
CountryCode: US
TelephoneNumber: 8654813163
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/16/2019
LastUpdateDate: 09/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X041578NYN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X13692TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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