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General NPI Number Information
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NPI Number | 1427678069
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Entity Type | Organization
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Legal Business Name | PRO CARE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 105 CENTER PARK DR STE 101
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City | KNOXVILLE
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State | TN
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Zip | 37922-3470
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Country | US
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Telephone | 865-335-3035
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Fax |
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Provider Business Mailing Address
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Address Line | 2623 BROOKE WILLOW BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37932-1894
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Country | US
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Telephone | 865-591-8477
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Fax |
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Authorized Official
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Title or Position | MANAGER AND SOLE MEMBER
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Name | DR. LAUREN ELIZABETH MACGUIRE BOLLING
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Credential | DPT
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Telephone | 865-591-8477
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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 |
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License Number State |
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