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General NPI Number Information
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NPI Number | 1487573036
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Entity Type | Individual
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Provider Name | MR. THOMAS HENRY LAZZARI
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Gender | Male
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 933 US-29 N, ATHENS, GA 30601
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City | ATHENS
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State | GA
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Zip | 30601
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Country | US
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Telephone | 762-499-6364
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 OCONEE FOREST DR
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2499
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Country | US
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Telephone | 706-424-1124
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 005451
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License Number State | GA
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