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NPI Code Detail

MEDICARE: DR. GREGORY ROSS CHANNELL DPT, MOT

MEDICARE: DR. GREGORY ROSS CHANNELL DPT, MOT
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 Therapist8573TN
2225X00000XOccupational Therapist4143TN

General Provider Information

NPI Number : 1619272416
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY ROSS CHANNELL DPT, MOT
Provider Business Mailing Address
First Line : 8309 ASHEVILLE HWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37924-4102
Country : US
Telephone Number : 865-932-1334
Fax Number : 865-932-1374
Provider Business Practice Location Address
First Line : 8309 ASHEVILLE HWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37924-4102
Country : US
Telephone Number : 865-932-1334
Fax Number : 865-932-1374
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2011
Last Update Date : 01/26/2011

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