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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