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Organization
CHAMPION PHYSICAL THERAPY LLC HALLS
Active
Organization
CHAMPION PHYSICAL THERAPY LLC HALLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD C. ROUSH (EXECUTIVE VICE PRESIDENT)
(419) 221-6712
Entity
Organization
Contact information
Practice address
7228 NORRIS FWY, KNOXVILLE, TN 37918-5744
(865) 300-0512
Mailing address
1110 SHAWNEE RD, LIMA, OH 45805-3529
(419) 221-6717
(419) 222-0507
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013404409
NPI
TN
01
—
1013404516
NPI
TN
01
—
1083101448
NPI
TN
01
—
1083101463
NPI
TN
01
—
1285121673
NPI
TN
01
—
1316434764
NPI
TN
01
—
1396232682
NPI
TN
01
—
1396232781
NPI
TN
01
—
1528555992
NPI
TN
01
—
1558858902
NPI
TN
01
—
1841787207
NPI
TN
01
—
1902393291
NPI
TN
01
—
1922595388
NPI
TN
01
—
3650169
MEDICARE PART B
TN
Enumeration date
05/30/2008
Last updated
01/23/2019
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