Healthcare Provider Details

I. General information

NPI: 1881640001
Provider Name (Legal Business Name): RAYMOND R. PIERCE M.S., P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 EMORY VALLEY RD SUITE A
OAK RIDGE TN
37830-7763
US

IV. Provider business mailing address

661 EMORY VALLEY RD SUITE A
OAK RIDGE TN
37830-7763
US

V. Phone/Fax

Practice location:
  • Phone: 865-483-0383
  • Fax: 865-483-0533
Mailing address:
  • Phone: 865-483-0383
  • Fax: 865-483-0533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1362
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: