=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306652524
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FREER MOBILE HAND THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2024
-----------------------------------------------------
Last Update Date | 01/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 116 AGNES RD STE 200
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37919-6306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-921-4241
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 116 AGNES RD STE 200
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37919-6306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-309-4663
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CERTIFIED HAND THERAPIST
-----------------------------------------------------
Name | CARMEN MARIE FREER
-----------------------------------------------------
Credential | OTR/L, CHT
-----------------------------------------------------
Telephone | 865-309-4663
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------