Provider Demographics
NPI:1003413006
Name:REED, LARRY HAL (PT)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:HAL
Last Name:REED
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 OWL HOLE GAP RD
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37861-4447
Mailing Address - Country:US
Mailing Address - Phone:865-604-9019
Mailing Address - Fax:
Practice Address - Street 1:1751 W MORRIS BLVD STE 1
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-3870
Practice Address - Country:US
Practice Address - Phone:423-839-0423
Practice Address - Fax:423-839-0423
Is Sole Proprietor?:No
Enumeration Date:2020-10-03
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist