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NPI Code Detail

MEDICARE: MRS. TRACY MULLINS OTR

MEDICARE: MRS. TRACY MULLINS OTR
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
1225X00000XOccupational Therapist2868TN

General Provider Information

NPI Number : 1225121429
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACY MULLINS OTR
Provider Business Mailing Address
First Line : 9047 EXECUTIVE PARK DR
Second Line : SUITE 115
City : KNOXVILLE
State : TN
Zip : 37923-4605
Country : US
Telephone Number : 865-531-5820
Fax Number : 865-539-6461
Provider Business Practice Location Address
First Line : 9047 EXECUTIVE PARK DR
Second Line : SUITE 115
City : KNOXVILLE
State : TN
Zip : 37923-4605
Country : US
Telephone Number : 865-531-5820
Fax Number : 865-539-6461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/27/2007

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Directions to “ MRS. TRACY MULLINS OTR” Practice Location

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