| Doctor Name: | JARROD LUMMIS |
| NPI Number: | 1194098517 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 2012004495 |
| Business Practice Address: | 188a Medical Dr Hannibal, MO - 634016877 |
| Business Phone Number: | 5734060576 |
| Business Fax Number: | 5734061371 |
| Mailing Address: | 188a Medical Dr, HANNIBAL |
| State: | MO |
| Postal Code: | 634016877 |
| Phone Number: | 5734060576 |
| Fax Number: | 5734061371 |
| NPI Enumeration Date: | 02/15/2012 |
| NPI Last Update Date: | 02/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 2012004495 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |