Organization
SHORELINE DOCKS INCORPPRATED
Active
Parent organization
MAX POTENTIAL REHAB INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAX POTENTIAL REHAB INC
Authorized official
JASON MARTIN LPTA (OWNER)
(865) 776-1063
Entity
Organization
Contact information
Practice address
7905 CODY LN, KNOXVILLE, TN 37938-3172
(865) 776-1063
Mailing address
PO BOX 70188, KNOXVILLE, TN 37938-0188
(865) 776-1063
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
2251G0304X
Geriatric Physical Therapist
3409
TN
2251H1300X
Human Factors Physical Therapist
3409
TN
2251N0400X
Neurology Physical Therapist
3409
TN
2251S0007X
Sports Physical Therapist
3409
TN
2251X0800X
Orthopedic Physical Therapist
3409
TN
225200000X
Physical Therapy Assistant
Primary
3409
TN
225X00000X
Occupational Therapist
—
—
320700000X
Physical Disabilities Residential Treatment Facility
3409
TN
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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