Organization
JOHNSON CITY PHYSICAL OCCUPATIONAL SPEECH OUTPATIENT THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LANCE A PATE M.A. CCC-SLP (OWNER)
(904) 509-7100
Entity
Organization
Contact information
Practice address
234 E MAIN ST, JOHNSON CITY, TN 37604-5708
(904) 509-7100
Mailing address
234 E MAIN ST, JOHNSON CITY, TN 37604-5708
(904) 509-7100
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
672988
TN
Other
Enumeration date
12/07/2011
Last updated
12/10/2011
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