Individual
OLEG URBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1018 W MAIN ST, LEBANON, TN 37087-3302
(615) 466-5200
(615) 466-5206
Mailing address
521 WEST MAIN STREET, LEBANON, TN 37087
(615) 444-9400
(615) 444-9406
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2145
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3658040
—
TN
Enumeration date
08/04/2005
Last updated
05/26/2009
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