MEDICARE: DANA L NEAR DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	6470	TN

General Provider Information

NPI Number	:	1093484669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA L NEAR DPT

Provider Business Mailing Address
First Line	:	425 OLD RICEVILLE RD STE 1
Second Line	:
City	:	ATHENS
State	:	TN
Zip	:	37303-3072
Country	:	US
Telephone Number	:	423-744-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 OLD RICEVILLE RD STE 1
Second Line	:
City	:	ATHENS
State	:	TN
Zip	:	37303-3072
Country	:	US
Telephone Number	:	423-744-0002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	09/08/2021

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Directions to “ DANA L NEAR DPT” Practice Location

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