Provider Demographics
NPI:1134193899
Name:AYERS, JOSEPH BLAKE (ATC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:BLAKE
Last Name:AYERS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GATLINBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37738-4446
Mailing Address - Country:US
Mailing Address - Phone:865-679-5699
Mailing Address - Fax:865-429-6657
Practice Address - Street 1:709 MIDDLE CREEK RD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5047
Practice Address - Country:US
Practice Address - Phone:865-429-6538
Practice Address - Fax:865-429-6657
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer