Basic Information
| Provider Information | |||||||||
| NPI: | 1235517038 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESMAILI JAVADI LANGEROUDI | ||||||||
| FirstName: | NAZANIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5500 MARYLAND WAY # 400 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370274948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444077557 | ||||||||
| FaxNumber: | 6156289301 | ||||||||
| Practice Location | |||||||||
| Address1: | 415 BROCKMAN MCCLIMON RD | ||||||||
| Address2: | |||||||||
| City: | GREER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296516608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8649891432 | ||||||||
| FaxNumber: | 8649891462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2015 | ||||||||
| LastUpdateDate: | 05/12/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 7216 | SC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.