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General NPI Number Information
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NPI Number | 1033999636
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Entity Type | Individual
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Provider Name | JAMES CLAYTON FIEGLE JR. OT/L
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Gender | Male
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 7512 MIDDLEBROOK PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37909-2349
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Country | US
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Telephone | 865-604-8109
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Fax |
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Provider Business Mailing Address
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Address Line | 258 CRUZE RD
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City | POWELL
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State | TN
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Zip | 37849-7703
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Country | US
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Telephone | 865-604-8109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2464
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License Number State | TN
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