Jeffrey D Lansdale
Individual provider Active NPI Physical Therapist · Humboldt, TN
NPI 1477967602 · NPPES record last updated Jun 16, 2014
Key facts
- NPI
- 1477967602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2379 (TN)
- Practice address
- 3525 Chere Carol Rd
Humboldt, TN 38343-3638 - Phone
- (731) 824-5551
- Fax
- (731) 824-5139
- NPI assigned
- Jun 16, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2379 | TN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2379 | TN | Yes |
Addresses
Primary practice location
3525 Chere Carol Rd
Humboldt, TN 38343-3638
Mailing address
3525 Chere Carol Rd
Humboldt, TN 38343-3638
Phone (731) 824-5551
Other providers in Humboldt, TN
- Nada Kattoum
- John Kelly
- Keith Kirby
- Marcia Ann Krokowski
- L B McClaren
- Rosalyn Taylor Laster
- Gina Eason Lee
- LTC Therapy Solutions LLC
- Dulce F Madrid
- Joseph Cecil Mallette
All providers in Humboldt, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2014. 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.