Organization
FULL SPECTRUM PEDIATRIC THERAPY, INC.
Active
Organization
FULL SPECTRUM PEDIATRIC THERAPY, INC.
Active
Other names
Full Spectrum Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LANA KAREEN BROOME OTR/L (OWNER/PRESIDENT)
(931) 906-0440
Entity
Organization
Contact information
Practice address
298 WARFIELD BLVD, SUITE C, CLARKSVILLE, TN 37043-1896
(931) 906-0440
(931) 920-5070
Mailing address
298 WARFIELD BLVD, SUITE C, CLARKSVILLE, TN 37043-1896
(931) 906-0440
(931) 920-5070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 6520
TN
225X00000X
Occupational Therapist
OT 2156
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4004828
TENNCARE PROVIDER NUMBER
TN
Enumeration date
02/09/2007
Last updated
04/20/2022
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