Provider Demographics
NPI:1891295879
Name:DELK, AUSTIN HARRIS (DPT)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:HARRIS
Last Name:DELK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 930402
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-0402
Mailing Address - Country:US
Mailing Address - Phone:865-671-3094
Mailing Address - Fax:865-888-9381
Practice Address - Street 1:11135 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:FARRAGUT
Practice Address - State:TN
Practice Address - Zip Code:37934-2807
Practice Address - Country:US
Practice Address - Phone:865-671-3094
Practice Address - Fax:865-671-3094
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP17499225100000X
TN11578225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist