Provider Demographics
NPI:1679244123
Name:LARRY REED PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LARRY REED PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:865-934-8581
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:865-934-8581
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy