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General NPI Number Information
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NPI Number | 1699105049
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Entity Type | Organization
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Legal Business Name | ADVANCED REHABILITATION & PAIN MANAGEMEN
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 327 SWEETGUM DR
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City | KNOXVILLE
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State | TN
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Zip | 37934-0844
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Country | US
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Telephone | 770-485-1447
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Fax |
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Provider Business Mailing Address
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Address Line | 327 SWEETGUM DR
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City | KNOXVILLE
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State | TN
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Zip | 37934-0844
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Country | US
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Telephone | 770-485-1447
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. MAGED ABDU
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Credential | P.T
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Telephone | 885-661-2787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT0000004178
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License Number State | TN
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