Provider Demographics
NPI:1477098374
Name:ROLLINS, JOSEPH THOMAS
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:ROLLINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 CAVE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-7969
Mailing Address - Country:US
Mailing Address - Phone:615-499-0333
Mailing Address - Fax:
Practice Address - Street 1:1 CUMBERLAND SQ
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3408
Practice Address - Country:US
Practice Address - Phone:865-617-3252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer