Provider Demographics
NPI:1548838592
Name:KNOX, CONNIE B
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:B
Last Name:KNOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:B
Other - Last Name:DOCKERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:177 BERRY DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-5824
Mailing Address - Country:US
Mailing Address - Phone:423-519-2664
Mailing Address - Fax:
Practice Address - Street 1:616 CONGRESS PKWY N
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-1600
Practice Address - Country:US
Practice Address - Phone:423-744-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4435225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant