Provider Demographics
NPI:1174553499
Name:GRASS, TOMASZ STEFAN (PT)
Entity type:Individual
Prefix:
First Name:TOMASZ
Middle Name:STEFAN
Last Name:GRASS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9257 MIDDLEBROOK PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-4700
Mailing Address - Country:US
Mailing Address - Phone:865-566-0100
Mailing Address - Fax:865-566-0099
Practice Address - Street 1:9257 MIDDLEBROOK PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-4700
Practice Address - Country:US
Practice Address - Phone:865-566-0100
Practice Address - Fax:865-566-0099
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3659177Medicaid
TN4079367OtherBCBS