Provider Demographics
NPI:1255354205
Name:LANIER-HACKETT, CHANDELLE (PT)
Entity type:Individual
Prefix:MRS
First Name:CHANDELLE
Middle Name:
Last Name:LANIER-HACKETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131-B1 N CASTLE HEIGHTS AVENUE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-5640
Mailing Address - Country:US
Mailing Address - Phone:615-965-9000
Mailing Address - Fax:615-965-9001
Practice Address - Street 1:1131-B1 N CASTLE HEIGHTS AVENUE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-5640
Practice Address - Country:US
Practice Address - Phone:615-965-9000
Practice Address - Fax:615-965-9001
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT 6531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist