Individual
MR. LANNY RAY BETHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
640 HANNINGS LN, MARTIN, TN 38237-3308
(731) 587-3193
(731) 588-2732
Mailing address
525 MOUNT PELIA RD APT 16, MARTIN, TN 38237-3398
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2032
TN
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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