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General NPI Number Information
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NPI Number | 1659365757
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Entity Type | Organization
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Legal Business Name | TENNESSEE THERAPEUTICS, INC.
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 110 SKYLINE DR STE B
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City | MAYNARDVILLE
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State | TN
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Zip | 37807-3063
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Country | US
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Telephone | 865-992-6933
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Fax | 865-992-6870
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Provider Business Mailing Address
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Address Line | 110 SKYLINE DR STE B
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City | MAYNARDVILLE
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State | TN
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Zip | 37807-3063
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Country | US
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Telephone | 865-992-6933
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Fax | 865-992-6870
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Authorized Official
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Title or Position | V PRESIDENT
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Name | MS. AGNES RAFANAN ABELLA
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Credential | PT
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Telephone | 865-992-6933
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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 | TN
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