Organization
FUNCTIONAL PATHWAYS PREFERRED OF TENNESSEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI L MCCULLOUGH (CFO)
(888) 531-2204
Entity
Organization
Contact information
Practice address
10133 SHERRILL BLVD, SUITE 200, KNOXVILLE, TN 37932-3347
(888) 531-2204
(855) 232-8604
Mailing address
10133 SHERRILL BLVD, SUITE 200, KNOXVILLE, TN 37932-3347
(888) 531-2204
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098417
—
WI
Enumeration date
01/13/2012
Last updated
01/19/2021
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