Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Impact Physical Therapy, LLC

Organization Physical Therapist · NPI 1174709430

Impact Physical Therapy, LLC is a Physical Therapist in Lebanon, Tennessee. Registered with an NPI since 2008.

In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1430 W Baddour Pkwy Ste C
Lebanon, TN 37087-2514
Phone: (615) 453-1422
Fax: (615) 453-1429
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1174709430
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Boucher — Owner · (615) 453-1422
NPI enumeratedJanuary 17, 2008
Last updated in NPPESMay 12, 2023
Certification dateMay 12, 2023
Mailing address1430 W Baddour Pkwy Ste C, Lebanon, TN 37087-2656

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