Individual
JUSTIN LANCE FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, BS
Contact information
Practice address
406 S MAIN ST, WINNSBORO, TX 75494-3226
(903) 342-6790
Mailing address
1130 E HAWKINS PKWY APT 6304, LONGVIEW, TX 75605-8143
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2138895
TX
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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