Provider Demographics
NPI:1164641114
Name:NASH, LOIS A (PTA)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:A
Last Name:NASH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 E PUGH DR
Mailing Address - Street 2:SUITE 28
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-3942
Mailing Address - Country:US
Mailing Address - Phone:812-232-1776
Mailing Address - Fax:812-232-3084
Practice Address - Street 1:1400 E PUGH DR
Practice Address - Street 2:SUITE 28
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-3942
Practice Address - Country:US
Practice Address - Phone:812-232-1776
Practice Address - Fax:812-232-3084
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06000187A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant