Organization
INDEPENDENT PHYSICAL THERAPY
Active
Other names
BenchMark
Organization subpart
No
Provider details
NPI number
Authorized official
MARVETTE WALLACE (DIRECTOR - CONTRACT MANAGEMENT)
(423) 238-8907
Entity
Organization
Contact information
Practice address
2324 MARKET PLACE DR, MARYVILLE, TN 37801-8704
(865) 643-8681
(865) 643-8682
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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