Healthcare Provider Details

I. General information

NPI: 1871626895
Provider Name (Legal Business Name): EAST TENNESSEE EMG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 MABRY HOOD ROAD SUITE #301
KNOXVILLE TN
37932
US

IV. Provider business mailing address

614 MABRY HOOD RD SUITE #301
KNOXVILLE TN
37932-2669
US

V. Phone/Fax

Practice location:
  • Phone: 865-531-2204
  • Fax: 888-291-0133
Mailing address:
  • Phone: 865-531-2204
  • Fax: 888-291-0133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL KNORR
Title or Position: PRESIDENT
Credential:
Phone: 865-531-2204