Organization
EAST TENNESSEE SPINE & SPORT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY JOHN DEFILIPPO PHYSICAL THERAPIST (PRESIDENT OWNER)
(865) 689-8299
Entity
Organization
Contact information
Practice address
150 N MARTINWOOD RD, SUITE 402, KNOXVILLE, TN 37923-5124
(865) 691-5020
(865) 691-5009
Mailing address
4905 N BROADWAY ST, KNOXVILLE, TN 37918-2315
(865) 689-8299
(865) 689-9804
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3650983
—
TN
Enumeration date
10/02/2006
Last updated
08/22/2020
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