Healthcare Provider Details

I. General information

NPI: 1093906190
Provider Name (Legal Business Name): KNOXVILLE PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 S CONCORD ST
KNOXVILLE TN
37919-3309
US

IV. Provider business mailing address

709 S CONCORD ST
KNOXVILLE TN
37919-3309
US

V. Phone/Fax

Practice location:
  • Phone: 865-637-2321
  • Fax:
Mailing address:
  • Phone: 865-637-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0000000870
License Number StateTN

VIII. Authorized Official

Name: LINDA K GOUGE
Title or Position: OWNER/PRESIDENT
Credential: P.T.
Phone: 865-637-2321