Individual
ENID K TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
150 N MARTINWOOD, SUITE 402, KNOXVILLE, TN 37923-5124
(865) 691-5020
(865) 691-5009
Mailing address
4905 N BROADWAY, KNOXVILLE, TN 37918-2315
(865) 689-8299
(865) 689-9804
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5962
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4016370
BLUE CROSS BLUE SHIELD
TN
Enumeration date
10/06/2006
Last updated
07/08/2007
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