Healthcare Provider Details

I. General information

NPI: 1053717330
Provider Name (Legal Business Name): CAROLYN PLATT LUCAS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2014
Last Update Date: 01/03/2021
Certification Date: 01/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206A COOL SPRINGS BLVD STE 106
FRANKLIN TN
37067-7277
US

IV. Provider business mailing address

405 OLDENBURG RD
NOLENSVILLE TN
37135-0616
US

V. Phone/Fax

Practice location:
  • Phone: 713-858-2940
  • Fax:
Mailing address:
  • Phone: 713-858-2940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10104
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: