Provider Demographics
NPI:1740472901
Name:TALLAHASSEE ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Entity type:Organization
Organization Name:TALLAHASSEE ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-219-1520
Mailing Address - Street 1:PO BOX 13269
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-3269
Mailing Address - Country:US
Mailing Address - Phone:850-219-1520
Mailing Address - Fax:850-219-1521
Practice Address - Street 1:3231 CAPITAL MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4413
Practice Address - Country:US
Practice Address - Phone:850-219-1520
Practice Address - Fax:850-219-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty