Healthcare Provider Details

I. General information

NPI: 1295823722
Provider Name (Legal Business Name): ANDREW E SMITH M.S., P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 MINERAL SPRINGS AVE
KNOXVILLE TN
37917-1562
US

IV. Provider business mailing address

1234 HARRINGTON DR
KNOXVILLE TN
37922-8020
US

V. Phone/Fax

Practice location:
  • Phone: 865-687-4537
  • Fax: 865-687-5367
Mailing address:
  • Phone: 865-687-4537
  • Fax: 865-687-5367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0728
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: