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General NPI Number Information
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NPI Number | 1134193899
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Entity Type | Individual
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Provider Name | JOSEPH BLAKE AYERS ATC
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Gender | Male
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 709 MIDDLE CREEK RD
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City | SEVIERVILLE
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State | TN
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Zip | 37862-5047
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Country | US
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Telephone | 865-429-6538
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Fax | 865-429-6657
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Provider Business Mailing Address
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Address Line | 567 EDGEWOOD DR
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City | GATLINBURG
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State | TN
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Zip | 37738-4446
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Country | US
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Telephone | 865-679-5699
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Fax | 865-429-6657
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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