Individual
ANN E BLACKWOOD-WIDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11440 PARKSIDE DR, SUITE 301, KNOXVILLE, TN 37934-2658
(865) 777-3748
(865) 777-3827
Mailing address
2725 WATER RIDGE PKWY, SUITE 300, CHARLOTTE, NC 28217-4580
(704) 831-5065
(704) 831-5066
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6135
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15751
FLORIDA LICENSE
FL
01
—
2305205029
VIRGINIA LICENSE
VA
01
—
6135
TN LICENSE
TN
Enumeration date
04/07/2008
Last updated
04/07/2008
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