Provider Demographics
NPI:1790036473
Name:SMITH, GABRIELLE CATHERINE (PT)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:CATHERINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:CATHERINE
Other - Last Name:KAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:10910 KINGSTON PIKE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2948
Mailing Address - Country:US
Mailing Address - Phone:865-342-7823
Mailing Address - Fax:865-342-7824
Practice Address - Street 1:10910 KINGSTON PIKE
Practice Address - Street 2:SUITE 107
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2948
Practice Address - Country:US
Practice Address - Phone:865-342-7823
Practice Address - Fax:865-342-7824
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist