Individual
MS. MARY K. KEARSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2910 TAZEWELL PIKE, KNOXVILLE, TN 37918-1879
(865) 687-1512
(865) 687-2138
Mailing address
1400 DOWELL SPRINGS BLVD, STE 120, KNOXVILLE, TN 37909-2450
(865) 232-1415
(865) 232-1416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6119
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3154490
BLUE CROSS
TN
05
—
3652954
—
TN
01
—
CH4394
MEDICARE-RAILROAD GROUP ID
TN
Enumeration date
05/16/2006
Last updated
04/08/2019
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