Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 12673 | TN |
N | 2251G0304X | Physical Therapist - Geriatrics | 3415 | CO |
NPI | 1033248406 |
---|---|
Provider Name | Charlene G. Mcglasson |
First Address | Knoxville, TN 37930-2569 |
Second Address | Hendersonville, TN 37075-1588 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2007 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0446631 | (05) | TN |