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Individual

KELLIE MCCORMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
11719 CHAPMAN HWY STE 104, SEYMOUR, TN 37865-5264
(865) 773-0479
Mailing address
1444 KAY VIEW DR, SEVIERVILLE, TN 37876-0268
(865) 254-7194

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12505
TN

Other

Enumeration date
08/20/2019
Last updated
08/20/2019
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