Healthcare Provider Details

I. General information

NPI: 1285544346
Provider Name (Legal Business Name): MORGAN KATE PENDLETON PT, DPT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PROFESSIONAL PARK DR
JOHNSON CITY TN
37604-6529
US

IV. Provider business mailing address

3 PROFESSIONAL PARK DR
JOHNSON CITY TN
37604-6529
US

V. Phone/Fax

Practice location:
  • Phone: 423-926-4331
  • Fax: 423-926-5767
Mailing address:
  • Phone: 423-926-4331
  • Fax: 423-926-5767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17200
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: