| Doctor Name: | DR. VICTOR OMOTAYO OMOTUNDE |
| NPI Number: | 1790969632 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T.,DPT |
| License Number: | PT0000003392 |
| Business Practice Address: | 3936 Altruria Rd Bartlett, TN - 381351547 |
| Business Phone Number: | 9019377641 |
| Business Fax Number: | 9019370712 |
| Mailing Address: | 3936 Altruria Rd, BARTLETT |
| State: | TN |
| Postal Code: | 381351547 |
| Phone Number: | 9019377641 |
| Fax Number: | 9019370712 |
| NPI Enumeration Date: | 12/27/2007 |
| NPI Last Update Date: | 12/27/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT0000003392 |
| 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 |