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General NPI Number Information
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NPI Number | 1740653435
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Entity Type | Individual
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Provider Name | KRISTINE BEDELL MONGAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 4905 N BROADWAY ST
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City | KNOXVILLE
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State | TN
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Zip | 37918-2315
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Country | US
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Telephone | 865-689-8299
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Fax | 865-689-9804
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Provider Business Mailing Address
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Address Line | 4905 N BROADWAY ST
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City | KNOXVILLE
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State | TN
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Zip | 37918-2315
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Country | US
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Telephone | 865-689-8299
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Fax | 865-689-9804
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2305209487
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License Number State | VA
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