Individual
LISA RENEE WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
201 N OAK AVE, COOKEVILLE, TN 38501-2437
(931) 528-2128
(931) 372-8679
Mailing address
201 N OAK AVE, COOKEVILLE, TN 38501-2437
(931) 528-2128
(931) 372-8679
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000000442
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
446592
—
TN
Enumeration date
08/15/2017
Last updated
07/21/2022
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