Healthcare Provider Details

I. General information

NPI: 1932877495
Provider Name (Legal Business Name): JOSEPH GAYLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 S MALL RD NE
KNOXVILLE TN
37917-2113
US

IV. Provider business mailing address

443 WINNERS CIR
SEYMOUR TN
37865-5986
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13861
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: