Basic Information
Provider Information
NPI: 1073031068
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAY
FirstName: JOSHUA
MiddleName: MARK
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 CRESCENT CENTRE DR STE 600
Address2:  
City: FRANKLIN
State: TN
PostalCode: 370677286
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 8110 CAMP CREEK RD STE 106
Address2:  
City: OLIVE BRANCH
State: MS
PostalCode: 386541622
CountryCode: US
TelephoneNumber: 6628931933
FaxNumber: 6628931934
Other Information
ProviderEnumerationDate: 08/30/2017
LastUpdateDate: 08/30/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

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

No ID Information.


Home