Individual
CALEB PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
110 E CENTER ST, KINGSPORT, TN 37660-4230
(423) 765-1611
(423) 765-1612
Mailing address
406 ROY MARTIN RD STE 9, GRAY, TN 37615-2245
(423) 477-1011
(423) 477-1102
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10746
TN
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
10746
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10746
TN BOARD OF PT
TN
01
—
6066842
BLUE CROSS BLUE SHIELD TN
TN
05
—
Q022042
—
TN
Enumeration date
02/11/2016
Last updated
01/16/2020
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