Healthcare Provider Details

I. General information

NPI: 1588899017
Provider Name (Legal Business Name): CAROLINA SUMNER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MONTBROOK LN STE 203
KNOXVILLE TN
37919-2715
US

IV. Provider business mailing address

430 MONTBROOK LN STE 203
KNOXVILLE TN
37919-2715
US

V. Phone/Fax

Practice location:
  • Phone: 865-337-5574
  • Fax: 865-313-2461
Mailing address:
  • Phone: 865-584-1054
  • Fax: 865-588-8350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8243
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: