Provider Demographics
NPI:1659623932
Name:NASH, TOMMY LEE JR
Entity Type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:LEE
Last Name:NASH
Suffix:JR
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 1:824 CEDAR CREST DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5146
Mailing Address - Country:US
Mailing Address - Phone:405-210-5891
Mailing Address - Fax:
Practice Address - Street 1:824 CEDAR CREST DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5146
Practice Address - Country:US
Practice Address - Phone:405-210-5891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor