Healthcare Provider Details

I. General information

NPI: 1659945244
Provider Name (Legal Business Name): CHRISTOPHER HERSTEK DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5822 LYONS VIEW PIKE STE B
KNOXVILLE TN
37919-6493
US

IV. Provider business mailing address

5822 LYONS VIEW PIKE STE B
KNOXVILLE TN
37919-6493
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-6358
  • Fax: 865-909-9949
Mailing address:
  • Phone: 655-886-3588
  • Fax: 865-909-9949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0000013580
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: