Healthcare Provider Details

I. General information

NPI: 1285347690
Provider Name (Legal Business Name): MARITZA CUEVAS PT DPT LSVT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARITZA CUEVAS GONZALEZ

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 FOX RD STE 101
KNOXVILLE TN
37922-9000
US

IV. Provider business mailing address

111 FOX RD STE 101
KNOXVILLE TN
37922-9000
US

V. Phone/Fax

Practice location:
  • Phone: 965-351-0615
  • Fax: 865-622-9566
Mailing address:
  • Phone: 865-351-0615
  • Fax: 865-622-9566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14254
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: