Dylan Houseal
Individual provider Active NPI Physical Therapy Assistant · Lexington, TN
NPI 1104632066 · NPPES record last updated Dec 17, 2024
Key facts
- NPI
- 1104632066
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 8664 (TN)
- Practice address
- 9550 Highway 412 W Ste a
Lexington, TN 38351-5850 - Phone
- (731) 967-3224
- Fax
- (731) 967-3305
- NPI assigned
- Dec 5, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8664 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lift Therapy, Inc. | Past |
Accepting new patients | |
| Jackson Madison County General Hospital | Past |
Accepting new patients | |
| Pathways of Tennessee, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8664 | TN | Yes |
Addresses
Primary practice location
9550 Highway 412 W Ste a
Lexington, TN 38351-5850
Mailing address
257 Bancorp South Pkwy
Jackson, TN 38305-7582
Phone (731) 660-8781
Other providers in Lexington, TN
- Hometown Health and Wellness PLLC
- Abbey Hopper
- Deborah Hopper
- Kimberly Michelle Hopper
- Mark K Hopper
- Lee Ann Howard
- Kaylie Elizabeth Huddleston
- Randy Gene Huddleston
- David Heath Hueter
- Anita Mae Hurt
All providers in Lexington, TN · Physical Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.