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Organization

NANCY D. COGBURN

Active
Other names
Pediatric Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
NANCY COGBURN P.T., D.P.T. (OWNER)
(865) 654-2069
Entity
Organization

Contact information

Practice address
1759 SCENIC DR, MARYVILLE, TN 37803-5535
(865) 654-2069
(865) 233-2476
Mailing address
PO BOX 4471, MARYVILLE, TN 37802-4471
(865) 654-2069
(865) 233-2476

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0000010045
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1534803
TN
Enumeration date
02/11/2017
Last updated
02/11/2017
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