Provider Demographics
NPI:1104981513
Name:ADVANCED PHYSICAL THERAPY OF KNOXVILLE, INC.
Entity type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY OF KNOXVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:865-693-0018
Mailing Address - Street 1:300 PROSPERITY RD
Mailing Address - Street 2:SUITE #102
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4717
Mailing Address - Country:US
Mailing Address - Phone:865-693-0018
Mailing Address - Fax:865-693-0082
Practice Address - Street 1:300 PROSPERITY RD
Practice Address - Street 2:SUITE #102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4717
Practice Address - Country:US
Practice Address - Phone:865-693-0018
Practice Address - Fax:865-693-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3732713Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER