Provider Demographics
NPI:1205886843
Name:GLOWIENKA, LINDA K (PT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:K
Last Name:GLOWIENKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:K
Other - Last Name:SCOFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8663 MIDDLEBROOK PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-1612
Mailing Address - Country:US
Mailing Address - Phone:865-801-9380
Mailing Address - Fax:865-381-0707
Practice Address - Street 1:8663 MIDDLEBROOK PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-1612
Practice Address - Country:US
Practice Address - Phone:865-801-9380
Practice Address - Fax:865-381-0707
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN621225100000X
MD15713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3652743Medicaid
TN97535OtherBLUE CROSS
3652743Medicare UPIN