Healthcare Provider Details

I. General information

NPI: 1922218122
Provider Name (Legal Business Name): FUNCTIONAL PATHWAYS OF TENNESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 MABRY HOOD RD STE 301
KNOXVILLE TN
37932-2669
US

IV. Provider business mailing address

10133 SHERRIL BLVD SUITE 200
KNOXVILLE TN
37932-3347
US

V. Phone/Fax

Practice location:
  • Phone: 865-531-2204
  • Fax:
Mailing address:
  • Phone: 865-531-2204
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

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