EAST TENNESSEE PHYSICAL THERAPY,LLC (NPI# 1134504764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134504764 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE PHYSICAL THERAPY,LLC |
| Practice Address |
4357 Maynardville Hwy Maynardville TN 37807 |
| Practice Telephone | 8657451799 |
| Practice Fax Number | 8657451806 |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-07-24 |
| Authorized Official Name | DALE R CORUM II (PROVIDER/OWNER) |
| Authorized Official Telephone | 8657451799 |
| Authorized Official Credential | PT OCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
5712 | TN | Ambulatory Health Care Facilities |
| Street Address |
4357 MAYNARDVILLE HWY |
| City | MAYNARDVILLE |
| State | TN |
| Zip Code | 37807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982624250 | Dale R Corum II | Physical Therapist | 4357 Maynardville Hwy, Maynardville, TN 37807-3623 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368815 | Ian Carter Mccormick | Pharmacist | 2710 Maynardville Highway, Maynardville, TN 37807 | 2020-08-25 |
| 1053963975 | Maynardville Drug LLC | Pharmacy | 2975 Maynardville Hwy, Maynardville, TN 37807 | 2019-07-11 |
| 1811014533 | Leah Renee Lewis | Specialist/Technologist | 108 Harmon Drive, Maynardville, TN 37807 | 2007-03-26 |
| 1659497394 | Mohammad Bhidya Md PC | Nurse Practitioner | 2595 Maynardville Hwy, Maynardville, TN 37807 | 2007-03-22 |
| 1053350363 | Thomas J Demaro | Emergency Medicine | 598 John Deere Drive, Maynardville, TN 37807 | 2006-06-05 |
| 1881117521 | Kristy Michille Bolt | Registered Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807 | 2017-07-25 |
| 1275986333 | Ashley Nicole Russell | Counselor | 4330 Maynardville Hwy, Maynardville, TN 37807 | 2016-07-13 |
| 1962843409 | Mary Elizabeth Phillips | Social Worker | 4330 Maynardville Hwy, Maynardville, TN 37807 | 2013-07-12 |
| 1447500731 | Julie M Roberts | Pharmacist | 4344 Maynardville Hwy, Maynardville, TN 37807 | 2012-09-13 |
| 1669623898 | Stallion Medical Group P.C. | Family Medicine | 598 John Deere Drive, Maynardville, TN 37807 | 2008-10-07 |
| Find all providers in zip 37807 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659365757 | Tennessee Therapeutics, Inc. | Clinic/Center | 2945 Maynardville Hwy, Ste. 9, Maynardville, TN 37807-3251 | 2005-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831717271 | Agilitas Usa, Inc | Clinic/Center | 109 Del Rio Pike Ste 105, Franklin, TN 37064-2578 | 2020-07-13 |
| 1033737689 | Therapy Plus LLC | Clinic/Center | 4108 Asheville Hwy, Knoxville, TN 37914-3505 | 2020-07-10 |
| 1235754888 | Robert Hutchens | Clinic/Center | 871 Ridgeway Loop Rd Ste 100, Memphis, TN 38120-4026 | 2020-06-09 |
| 1841815628 | Mndfl Physio LLC | Clinic/Center | 405 Midnight Sun Cir, Nashville, TN 37211-6822 | 2020-06-08 |
| 1427678069 | Pro Care Physical Therapy, LLC | Clinic/Center | 105 Center Park Dr Ste 101, Knoxville, TN 37922-3470 | 2020-04-23 |
| 1548892086 | Joshua Gibson | Clinic/Center | 1142 Cliffview Cir, Gray, TN 37615-5211 | 2020-02-11 |
| 1841822525 | Fagan Geriatric Wellness and Rehabilitation | Clinic/Center | 143 E Prince St, Gallatin, TN 37066-2880 | 2020-02-10 |
| 1255978003 | Archer Physical Therapy, LLC | Clinic/Center | 1206b N 8th St, Nashville, TN 37207-5526 | 2019-11-27 |
| 1619519683 | Agilitas Usa, Inc | Clinic/Center | 627 S. James Campbell Blvd., Suite B, Columbia, TN 38401 | 2019-10-11 |
| 1033750310 | Nashville Physical Therapy & Performance, Pllc | Clinic/Center | 15115 Old Hickory Blvd Ste C, Nashville, TN 37211-6585 | 2019-10-08 |
| Find all providers with the same taxonomy | ||||
| City | MAYNARDVILLE |
| Zip Code | 37807 |
Please comment or provide details below to improve the information on EAST TENNESSEE PHYSICAL THERAPY,LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.