State of Tennessee
NPI #1477966976 in Greeneville, Tennessee
Provider Information
- NPI Number
- 1477966976
- Entity Type
- Organization
- Organization Name
- State of Tennessee
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- Jun 3, 2014
- Last Updated
- Jun 29, 2016
Practice Location
- Address
- 4850 E ANDREW JOHNSON HWY
- Address 2
- DIDD EAST TN SEATING AND POSITIONING CLINIC
- City
- Greeneville
- State
- Tennessee
- ZIP Code
- 37745-3098
- Phone
- (423) 787-6689
Authorized Official
- Name
- MR. LANCE DEREK IVERSON
- Title
- DEPUTY COMMISSIONER
- Phone
- (615) 253-6710
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
| Occupational Therapist |
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