Provider Demographics
NPI:1952634313
Name:EAST TENNESSEE OCCUPATIONAL THERAPY SERVICES, P.C.
Entity Type:Organization
Organization Name:EAST TENNESSEE OCCUPATIONAL THERAPY SERVICES, P.C.
Other - Org Name:ETOTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLAIBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:865-933-8246
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37871-0182
Mailing Address - Country:US
Mailing Address - Phone:865-933-8246
Mailing Address - Fax:865-465-3154
Practice Address - Street 1:8537 ASHEVILLE HWY
Practice Address - Street 2:SUITE 105
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-4116
Practice Address - Country:US
Practice Address - Phone:865-933-8246
Practice Address - Fax:865-465-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1034224Z00000X
TN2772225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty