Provider Demographics
NPI:1184272130
Name:BILLINGS, JUSTICE
Entity type:Individual
Prefix:
First Name:JUSTICE
Middle Name:
Last Name:BILLINGS
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 1:6840 BUNKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:DELLROSE
Mailing Address - State:TN
Mailing Address - Zip Code:38453-5105
Mailing Address - Country:US
Mailing Address - Phone:931-625-1549
Mailing Address - Fax:
Practice Address - Street 1:6840 BUNKER HILL RD
Practice Address - Street 2:
Practice Address - City:DELLROSE
Practice Address - State:TN
Practice Address - Zip Code:38453-5105
Practice Address - Country:US
Practice Address - Phone:931-625-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
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