Provider Demographics
NPI:1558316885
Name:CULBERT, ELAINE M (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:M
Last Name:CULBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 EMORY VALLEY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7763
Mailing Address - Country:US
Mailing Address - Phone:865-483-0383
Mailing Address - Fax:865-483-0533
Practice Address - Street 1:661 EMORY VALLEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7763
Practice Address - Country:US
Practice Address - Phone:865-483-0383
Practice Address - Fax:865-483-0533
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4088042OtherBLUE CROSS BLUE SHIELD
TN3658884OtherRAILROAD MEDICARE
TN3658884Medicaid
TN4088042OtherBLUE CROSS BLUE SHIELD