MEDICARE: KENNETH R CLOWERS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	7580	TN

General Provider Information

NPI Number	:	1376634667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH R CLOWERS P.T.

Provider Business Mailing Address
First Line	:	9600 BUCKHAVEN CT
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-2071
Country	:	US
Telephone Number	:	865-809-4927
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 LETORY RD
Second Line	:
City	:	WARTBURG
State	:	TN
Zip	:	37887-3224
Country	:	US
Telephone Number	:	423-346-3220
Fax Number	:	423-346-3223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	06/22/2019

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