Organization
NHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KAITLYN RICHESIN COTA/L (COTA/L)
(423) 745-0434
Entity
Organization
Contact information
Practice address
1204 FRYE ST, ATHENS, TN 37303-3052
(423) 745-0434
Mailing address
1204 FRYE ST, ATHENS, TN 37303-3052
(423) 745-0434
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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