MEDICARE: TRI-STATE FUNCTIONAL NEUROTHERAPY

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1437010733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-STATE FUNCTIONAL NEUROTHERAPY

Provider Business Mailing Address
First Line	:	116 AGNES RD STE 200
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-6306
Country	:	US
Telephone Number	:	423-558-9088
Fax Number	:

Provider Business Practice Location Address
First Line	:	7629 ROYAL HARBOUR CIR
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-9153
Country	:	US
Telephone Number	:	423-558-9088
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	T L BURTON
Credential	:	RN
Telephone Number	:	423-558-9088

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	03/13/2026

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1295735835 — DR. JAMES KEVIN GOROSPE PHARM.D.
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Directions to “TRI-STATE FUNCTIONAL NEUROTHERAPY ” Practice Location

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