Organization
SPEECH PATHOLOGY SERVICES OF EAST TENNESSEE LLC
Active
Other names
Radiant Comprehensive Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ANDREW BECKMANN JR. (COO)
(865) 982-3400
Entity
Organization
Contact information
Practice address
2030 CHILHOWEE MEDICAL PARK, MARYVILLE, TN 37804-5285
(865) 982-3400
(865) 238-2034
Mailing address
PO BOX 5209, MARYVILLE, TN 37802-5209
(865) 982-3400
(865) 238-2034
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446666
—
TN
01
—
2246342
CIGNA
TN
01
—
4049419
BLUE CROSS BLUE SHIELD
TN
01
—
702004062
CARITEN
TN
01
—
708669
UNITED HEALTH CARE
TN
Enumeration date
10/04/2006
Last updated
12/15/2021
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