Provider Demographics
NPI:1649570813
Name:WARMBROD, MARY C (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:C
Last Name:WARMBROD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:WARMBROD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:300 LABORATORY RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6911
Mailing Address - Country:US
Mailing Address - Phone:865-482-7698
Mailing Address - Fax:
Practice Address - Street 1:300 LABORATORY RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6911
Practice Address - Country:US
Practice Address - Phone:865-482-7698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist