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Organization
UNIVERSITY OF TENNESSEE
Active
Organization
UNIVERSITY OF TENNESSEE
Active
Other names
University Therapists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL COUNTS LIKENS PT, PHD, MBA (ASSOCIATE PROFESSOR AND CHAIRMAN)
(901) 448-5047
Entity
Organization
Contact information
Practice address
930 MADISON AVE, SUITE EC013, MEMPHIS, TN 38163-2243
(901) 448-6438
(901) 448-1411
Mailing address
920 MADISON AVE, SUITE 415, MEMPHIS, TN 38163-2243
(901) 448-6438
(901) 448-1411
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446645
—
TN
01
—
3133295
BC/BS PROVIDER NUMBER
TN
Enumeration date
09/27/2006
Last updated
11/30/2016
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