Ali Lannom

Individual provider Active NPI Occupational Therapist · Gordonsville, TN

NPI 1629675202 · NPPES record last updated Oct 6, 2020

Key facts

NPI
1629675202
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
6679 (TN)
Practice address
417 Gordonsville Hwy
Suite 100
Gordonsville, TN 38563
Phone
(615) 683-4195
NPI assigned
Oct 6, 2020
Sex
Female
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6679 TN Yes

Addresses

Primary practice location

417 Gordonsville Hwy
Suite 100
Gordonsville, TN 38563

Mailing address

PO Box 681478
Franklin, TN 37068-1478
Phone (615) 591-6590

Other identifiers

IdentifierTypeStateIssuer
0446631MedicaidTN

Other providers in Gordonsville, TN

All providers in Gordonsville, TN · Occupational Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.