Individual
CHARLES JACKSON BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
10133 SHERRILL BLVD STE 200, KNOXVILLE, TN 37932-3347
(888) 531-2204
(855) 232-8604
Mailing address
10133 SHERRILL BLVD STE 200, KNOXVILLE, TN 37932-3347
(888) 531-2204
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004344
GA
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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