Provider Demographics
NPI:1093484669
Name:NEAR, DANA L (DPT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:NEAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:L
Other - Last Name:MORROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:425 OLD RICEVILLE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-3072
Mailing Address - Country:US
Mailing Address - Phone:423-744-0002
Mailing Address - Fax:
Practice Address - Street 1:425 OLD RICEVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3072
Practice Address - Country:US
Practice Address - Phone:423-744-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist