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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