Provider Demographics
NPI:1689605610
Name:BRENDA RASCH, PT, PC
Entity Type:Organization
Organization Name:BRENDA RASCH, PT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:865-363-6416
Mailing Address - Street 1:9157 COLCHESTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-1460
Mailing Address - Country:US
Mailing Address - Phone:865-363-6416
Mailing Address - Fax:865-357-7704
Practice Address - Street 1:9025 STRAWFLOWER DR.
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-1460
Practice Address - Country:US
Practice Address - Phone:865-363-6416
Practice Address - Fax:865-357-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001267261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3732850Medicare PIN