Organization
RIVER REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON COOPER P.T. (OWNER/THERAPIST)
(865) 539-2606
Entity
Organization
Contact information
Practice address
139 FOX RD, SUITE 111, KNOXVILLE, TN 37922-3472
(865) 539-2606
(865) 539-2646
Mailing address
139 FOX RD, SUITE 111, KNOXVILLE, TN 37922-3472
(865) 539-2606
(865) 539-2646
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6034
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3659122
—
TN
01
—
4082601
BCBS
TN
Enumeration date
06/23/2006
Last updated
08/22/2020
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