Individual
JASON O KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1430 W. BADDOUR PARKWAY, SUITE A, LEBANON, TN 37087-2514
(615) 547-0874
(615) 547-0876
Mailing address
1430 W. BADDOUR PARKWAY, SUITE A, LEBANON, TN 37087-2514
(615) 547-0874
(615) 547-0876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6246
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6246
PHYSICAL THERAPY LICENSE
TN
Enumeration date
07/13/2006
Last updated
07/08/2007
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