Individual
IAN GORDON MACLEOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2648 SEVIERVILLE RD, MARYVILLE, TN 37804-3643
(865) 984-1660
Mailing address
2027 ISLAND HOME BLVD, KNOXVILLE, TN 37920-2740
(865) 237-3124
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7208
TN
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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