Provider Demographics
NPI:1881325561
Name:ATCHISON, MICHELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ATCHISON
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 1:832 CRASSULA WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-3021
Mailing Address - Country:US
Mailing Address - Phone:503-798-3689
Mailing Address - Fax:
Practice Address - Street 1:1250 TENNOVA MEDICAL WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3120
Practice Address - Country:US
Practice Address - Phone:865-895-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECP021701T225100000X
IA111327225100000X
TN14972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist