| Lauren Kristine Wilson, DPT | |
|
Po Box 80, Harrogate, TN 37752-0080 | |
| (423) 289-2026 | |
| Not Available |
| Full Name | Lauren Kristine Wilson |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | Po Box 80, Harrogate, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780076349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 006391 (Kentucky) | Secondary |
| 225100000X | Physical Therapist | 10983 (Tennessee) | Primary |
| Provider Name | East Tennessee Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1134504764 PECOS PAC ID: 7810294832 Enrollment ID: O20160318000133 |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren Kristine Wilson, DPT Po Box 80, Harrogate, TN 37752-0080 Ph: () - | Lauren Kristine Wilson, DPT Po Box 80, Harrogate, TN 37752-0080 Ph: (423) 289-2026 |
Megan Ford, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 362 Catalpa Ave, Harrogate, TN 37752 Phone: 423-869-9923 | |
Nicholas Boland, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 362 Catalpa Ave, Harrogate, TN 37752 Phone: 423-869-9923 | |
Michael Harris, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 362 Catalpa Ave, Harrogate, TN 37752 Phone: 423-869-9923 |