Provider Demographics
NPI:1578177424
Name:RACKLEY, EVE LORRAINE (PT)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:LORRAINE
Last Name:RACKLEY
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 1:9129 CROSS PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4505
Mailing Address - Country:US
Mailing Address - Phone:865-694-7725
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:576 FORT LOUDOUN MEDICAL CENTER DR STE 100A
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5676
Practice Address - Country:US
Practice Address - Phone:865-988-8796
Practice Address - Fax:865-988-8798
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist