Individual
LYDIA MARIE ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2090 W MADISON AVE, ATHENS, TN 37303-3950
(423) 405-3075
Mailing address
289 HOYAL LN, SPRING CITY, TN 37381-4124
(612) 816-6780
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7356
TN
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
06/15/2022
Last updated
07/21/2023
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