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General NPI Number Information
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NPI Number | 1659466712
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Entity Type | Organization
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Legal Business Name | SPEECH PATHOLOGY SERVICES OF EAST TENNESSEE LLC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 2030 CHILHOWEE MEDICAL PARK
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City | MARYVILLE
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State | TN
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Zip | 37804-5285
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Country | US
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Telephone | 865-982-3400
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Fax | 865-238-2034
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Provider Business Mailing Address
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Address Line | PO BOX 5209
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City | MARYVILLE
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State | TN
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Zip | 37802-5209
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Country | US
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Telephone | 865-982-3400
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Fax | 865-238-2034
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Authorized Official
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Title or Position | COO
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Name | JAMES ANDREW BECKMANN JR.
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Credential |
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Telephone | 865-982-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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