Individual
MR. MARK WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2120 HIGHLAND AVE, KNOXVILLE, TN 37916-1112
(865) 525-4131
Mailing address
2120 HIGHLAND AVE, KNOXVILLE, TN 37916-1112
(865) 525-4131
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4545
TN
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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