Provider Demographics
NPI:1477717601
Name:TRUMAN, LONNIE J (PT)
Entity Type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:J
Last Name:TRUMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:UT
Mailing Address - Zip Code:84725-0549
Mailing Address - Country:US
Mailing Address - Phone:775-726-3117
Mailing Address - Fax:775-726-3118
Practice Address - Street 1:660 E MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:ENTERPRISE
Practice Address - State:UT
Practice Address - Zip Code:84725
Practice Address - Country:US
Practice Address - Phone:435-878-2722
Practice Address - Fax:775-726-3118
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT294934-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist