Provider Demographics
NPI:1437010733
Name:TRI-STATE FUNCTIONAL NEUROTHERAPY
Entity type:Organization
Organization Name:TRI-STATE FUNCTIONAL NEUROTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:423-558-9088
Mailing Address - Street 1:7629 ROYAL HARBOUR CIR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-9153
Mailing Address - Country:US
Mailing Address - Phone:423-558-9088
Mailing Address - Fax:
Practice Address - Street 1:7629 ROYAL HARBOUR CIR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-9153
Practice Address - Country:US
Practice Address - Phone:423-558-9088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy