| Doctor Name: | LORI BEDERKA LONG |
| NPI Number: | 1447685151 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 6666 |
| Business Practice Address: | 621 Gracey Ave Clarksville, TN - 370404012 |
| Business Phone Number: | 4236221551 |
| Business Fax Number: | 8778567133 |
| Mailing Address: | Po Box 8114, CHATTANOOGA |
| State: | TN |
| Postal Code: | 374140114 |
| Phone Number: | 4236221551 |
| Fax Number: | 8778567133 |
| NPI Enumeration Date: | 09/12/2013 |
| NPI Last Update Date: | 09/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 6666 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |