Provider Demographics
NPI:1932293404
Name:LECATES, JEFFERSON DAVID SR (PTA)
Entity Type:Individual
Prefix:MR
First Name:JEFFERSON
Middle Name:DAVID
Last Name:LECATES
Suffix:SR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 BIRCHWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064
Mailing Address - Country:US
Mailing Address - Phone:615-790-7572
Mailing Address - Fax:
Practice Address - Street 1:812 NORTH CHARLOTTE STREET
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055
Practice Address - Country:US
Practice Address - Phone:615-446-8046
Practice Address - Fax:615-441-3138
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPTA596225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant