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Individual

JERRY LUCAS HENDRIX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
258 DALE HAVEN LN, TULLAHOMA, TN 37388-8006
(931) 581-8390
Mailing address
258 DALE HAVEN LN, TULLAHOMA, TN 37388-8006
(931) 581-8390

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
17409
AL
261QP2000X
Physical Therapy Clinic/Center
Primary
PT0000007480
TN

Other

Enumeration date
10/04/2005
Last updated
07/08/2014
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