Provider Demographics
NPI:1184357360
Name:LAMOTTE, TAYLOR BROOKE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:BROOKE
Last Name:LAMOTTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8407 HOUNDS RUN CT
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3056
Mailing Address - Country:US
Mailing Address - Phone:865-363-1178
Mailing Address - Fax:
Practice Address - Street 1:4905 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2315
Practice Address - Country:US
Practice Address - Phone:865-689-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist