Organization Name: | TRIKARE THERAPY SERVICES, LLC |
NPI Number: | 1225335185 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARLTON LAMAR LAWRENCE (PHYSICAL THERAPIST) |
Mailing Address: | 3210 Wheldon Way Douglasville |
State: | GA US |
Postal Code: | 301353107 |
Phone Number: | 6784677368 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2011 |
NPI Last Update Date: | 02/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP005137 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |