Healthcare Provider Details

I. General information

NPI: 1306523923
Provider Name (Legal Business Name): WILLIAM TERRY BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10133 SHERRILL BLVD
KNOXVILLE TN
37932-3347
US

IV. Provider business mailing address

3506 MADISON AVE
GREENSBORO NC
27403-1030
US

V. Phone/Fax

Practice location:
  • Phone: 865-392-2847
  • Fax:
Mailing address:
  • Phone: 336-558-8483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA1720
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: