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General NPI Number Information
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NPI Number | 1265685325
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Entity Type | Organization
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Legal Business Name | THERAKIDS INC.
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Dates
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Enumeration Date | 11/02/2008
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 10710 MURDOCK DR STE 102
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City | KNOXVILLE
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State | TN
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Zip | 37932-3257
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Country | US
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Telephone | 865-936-3455
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Fax | 865-671-2070
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Provider Business Mailing Address
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Address Line | 10710 MURDOCK DR STE 102
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City | KNOXVILLE
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State | TN
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Zip | 37932-3257
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Country | US
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Telephone | 865-936-3455
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMY SHUGART
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Credential |
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Telephone | 865-936-3455
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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 | 5067
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License Number State | TN
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