Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 7444 | TN |
NPI | 1013528546 |
---|---|
Provider Name | Joshua Lampert |
First Address | Cookeville, TN 38501-4667 |
Second Address | Crossville, TN 38555-4526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2020 |
Last Update Date | 10/08/2020 |