Organization
ADVANCED THERAPY OF KINGSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA M TALLEY P.T. (OWNER/P.T.)
(423) 230-6323
Entity
Organization
Contact information
Practice address
1101 E STONE DR STE 3, KINGSPORT, TN 37660-3384
(423) 230-6323
Mailing address
1101 E STONE DR STE 3, KINGSPORT, TN 37660-3384
(423) 230-6323
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/21/2009
Last updated
12/21/2009
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