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NPI Code Detail

MEDICARE: MISS MARILOU ABESAMIS ACOSTA PT

MEDICARE: MISS MARILOU ABESAMIS ACOSTA PT
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
1225100000XPhysical TherapistTN8275TN
2225100000XPhysical TherapistMO2007017263MO

General Provider Information

NPI Number : 1609164268
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MARILOU ABESAMIS ACOSTA PT
Provider Business Mailing Address
First Line : 3916 BOYDS BRIDGE PIKE
Second Line : HOLSTON HEALTH AND REHAB CENTER
City : KNOXVILLE
State : TN
Zip : 37914-6233
Country : US
Telephone Number : 865-524-1500
Fax Number : 865-524-0408
Provider Business Practice Location Address
First Line : 3916 BOYDS BRIDGE PIKE
Second Line : HOLSTON HEALTH AND REHAB CENTER
City : KNOXVILLE
State : TN
Zip : 37914-6233
Country : US
Telephone Number : 865-524-1500
Fax Number : 865-524-0408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2011
Last Update Date : 07/18/2011

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Directions to “ MISS MARILOU ABESAMIS ACOSTA PT” Practice Location

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