Provider Demographics
NPI:1316007719
Name:LIWAG, TIARA ASISTIN (PT)
Entity type:Individual
Prefix:
First Name:TIARA
Middle Name:ASISTIN
Last Name:LIWAG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TIARA ALEGRIA
Other - Middle Name:ASISTIN
Other - Last Name:LIWAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:119 WINDHAM CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-7083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:813 S DICKERSON RD
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1761
Practice Address - Country:US
Practice Address - Phone:615-859-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist