Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 10104 | TN |
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1053717330 |
---|---|
Provider Name | Dr. Carolyn Platt Lucas |
First Address | Nolensville, TN 37135-0616 |
Second Address | Franklin, TN 37067-7277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2014 |
Last Update Date | 03/01/2021 |