Provider Demographics
NPI:1760510739
Name:PHYSIOTHERAPY ASSOCIATES INC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-644-7824
Mailing Address - Street 1:10420 KINGSTON PIKE STE H
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3261
Mailing Address - Country:US
Mailing Address - Phone:865-690-5494
Mailing Address - Fax:865-693-6248
Practice Address - Street 1:8458 GLEASON DR APT 335
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5491
Practice Address - Country:US
Practice Address - Phone:865-690-5494
Practice Address - Fax:865-693-6248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446557Medicaid
TN446557Medicare Oscar/Certification