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Organization

LAKEWAY PHYSICAL THERAPY OUTPATIENT, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSELITO PASAOL PT (PRESIDENT)
(931) 232-4555
Entity
Organization

Contact information

Practice address
402-C CHURCH ST., DOVER, TN 37058
(931) 232-4555
(931) 232-4599
Mailing address
75 CASTLETON CV, PARIS, TN 38242-5942
(931) 232-4555

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
0590012
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1523011
TN
Enumeration date
12/08/2008
Last updated
03/19/2012
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