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General NPI Number Information
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NPI Number | 1114229226
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Entity Type | Organization
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Legal Business Name | FORWARD PHYSICAL THERAPY,LLC
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 9215 MIDDLEBROOK PIKE SUITE 400
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City | KNOXVILLE
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State | TN
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Zip | 37931-4737
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Country | US
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Telephone | 865-357-5088
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Fax | 865-357-5087
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Provider Business Mailing Address
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Address Line | 9215 MIDDLEBROOK PIKE SUITE 400
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City | KNOXVILLE
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State | TN
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Zip | 37931-4737
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Country | US
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Telephone | 865-357-5088
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Fax | 865-357-5087
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LAURA WEISBERG
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Credential | MPT
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Telephone | 865-357-5088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 0000005995
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License Number State | TN
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