Individual
MS. MARY LEAH MIZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8904 CROSS PARK DR, KNOXVILLE, TN 37923-4703
(865) 690-2671
(865) 690-6445
Mailing address
PO BOX 32709, KNOXVILLE, TN 37930-2709
(865) 558-6484
(865) 584-4037
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
8338
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514521
—
TN
01
—
4232090
BLUE CROSS BLUE SHIELD OF TN
TN
01
—
CH4394
MEDICARE RAILROAD-GROUP
TN
Enumeration date
06/26/2009
Last updated
06/24/2010
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