Provider Demographics
NPI:1639417967
Name:FELTNER, LISA D (DPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:D
Last Name:FELTNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MALLORY LN
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8233
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:2197 MADISON ST
Practice Address - Street 2:SUITE 106
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5284
Practice Address - Country:US
Practice Address - Phone:931-503-1700
Practice Address - Fax:615-221-9054
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9625225100000X
NCP15751225100000X
VA2305207691225100000X
NY041491-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist