=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053086306
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUTCHISON REHABILITATION, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2021
-----------------------------------------------------
Last Update Date | 08/10/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 312 S PETERS RD
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37923-5220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-985-0287
-----------------------------------------------------
Fax | 865-985-0289
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 312 S PETERS RD
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37923-5220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-985-0287
-----------------------------------------------------
Fax | 865-985-0289
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER/DIRECTOR
-----------------------------------------------------
Name | JOE HUTCHISON
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 865-805-7829
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------