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General NPI Number Information
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NPI Number | 1952634313
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Entity Type | Organization
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Legal Business Name | EAST TENNESSEE OCCUPATIONAL THERAPY SERVICES, P.C.
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 8537 ASHEVILLE HWY SUITE 105
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City | KNOXVILLE
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State | TN
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Zip | 37924-4116
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Country | US
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Telephone | 865-933-8246
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Fax | 865-465-3154
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Provider Business Mailing Address
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Address Line | PO BOX 182
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City | STRAWBERRY PLAINS
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State | TN
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Zip | 37871-0182
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Country | US
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Telephone | 865-933-8246
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Fax | 865-465-3154
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MELISSA J CLAIBORNE
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Credential | MS, OTR/L
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Telephone | 865-933-8246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1034
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2772
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License Number State | TN
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