Provider Demographics
NPI:1205495827
Name:CARTER, CRISTIN MICHELLE (PT DPT)
Entity type:Individual
Prefix:
First Name:CRISTIN
Middle Name:MICHELLE
Last Name:CARTER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 FOX ROAD
Mailing Address - Street 2:STE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-9000
Mailing Address - Country:US
Mailing Address - Phone:865-351-0615
Mailing Address - Fax:865-622-9566
Practice Address - Street 1:111 FOX RD STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-9000
Practice Address - Country:US
Practice Address - Phone:865-351-0615
Practice Address - Fax:865-622-9566
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist