Joel Amontos Lasig, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Wartburg, TN
NPI 1992989347 · NPPES record last updated Dec 20, 2007
Key facts
- NPI
- 1992989347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT0000004126 (TN)
- Practice address
- 108 Charles Bishop Rd
Wartburg, TN 37887-4092 - Phone
- (423) 346-1999
- NPI assigned
- Dec 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| PT0000004126 | TN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0000004126 | TN | Yes |
Addresses
Primary practice location
108 Charles Bishop Rd
Wartburg, TN 37887-4092
Mailing address
108 Charles Bishop Rd
Wartburg, TN 37887-4092
Phone (423) 346-1999
Other providers in Wartburg, TN
- Crystal Johnson
- Jerrica Ann Jones
- David D. Kelner
- Sydney Kidd
- Ionela M Krulewich
- Jonathan Ben Laymance
- Christina Long
- Catherine Lynn
- Tarrant Mehcole McCarley
- Jessica Mellard
All providers in Wartburg, 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 Dec 20, 2007. 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.