Individual
LISA MARIE GORTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
741 PRESIDENT PL, SUITE 130, SMYRNA, TN 37167-6807
(615) 220-0086
Mailing address
2001 MALLORY LN, SUITE 201, FRANKLIN, TN 37067-8233
(615) 373-1350
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8195
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3727276
GROUP MEDICAID LEGACY NUMBER
TN
Enumeration date
10/21/2008
Last updated
06/28/2023
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