Doctor Name: | LOGAN B. PENDERGRASS |
NPI Number: | 1124325808 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 8854 |
Business Practice Address: | 1422 Old Weisgarber Rd Knoxville, TN - 379091293 |
Business Phone Number: | 8655584480 |
Business Fax Number: | 8655584481 |
Mailing Address: | 1422 Old Weisgarber Rd, KNOXVILLE |
State: | TN |
Postal Code: | 379091293 |
Phone Number: | 8655584480 |
Fax Number: | 8655584481 |
NPI Enumeration Date: | 02/16/2011 |
NPI Last Update Date: | 04/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 8854 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |