State of Tennessee

NPI #1013329564 in Arlington, Tennessee

Provider Information

NPI Number: 1013329564
Entity Type: Organization
Organization Name: State of Tennessee
Primary Specialty: Occupational Therapist
Enumeration Date: Jun 2, 2014
Last Updated: Jun 29, 2016

Practice Location

Address: 11437 MILTON WILSON RD
Address 2: DIDD WEST TN SEATING AND POSITIONING CLINIC
City: Arlington
State: Tennessee
ZIP Code: 38002-4926
Phone: (901) 745-7509

Authorized Official

Name: MR. LANCE DEREK IVERSON
Title: DEPUTY COMMISSIONER
Phone: (615) 253-6710

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X
Occupational Therapist	225X00000X	Primary

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